smh1091 Posted April 28, 2014 Share Posted April 28, 2014 I had a question I'm hoping someone can help me with. I am a PA, but also am a Registered Dietitian and planning on becoming a Certified Diabetes Educator. I am trying to get a job in ideally endocrinology or GI, but am also applying to primary care. I know that I can bill as a dietitian through insurance for nutrition education. I have tried to research billable codes and it appears 97802, 97803 and 97804 are medical nutrition therapy billable codes. G0108 appears to be the code for diabetes education. However, it only appears that I can bill for those codes for diabetics and kidney failure patients. Does anyone know if I can bill those codes for medical nutrition therapy for other medical conditions, such as celiac disease, hyperlipidemia etc? Can I bill for medical nutrition therapy if I work for a GI, endocrinologist or primary care doc? Also, in negotiating for salary with the doctor's I do not want to price myself out and ask for too much money but also not ask for too little. I feel that if I can bill those codes as a dietitian, I will make the doctor more money and feel that I should ask for a somewhat higher salary than the average for that field. What would be a reasonable desired salary above the average if I am able to bill for these codes as a dietitian and diabetes educator? $5,000 more or $10,000 more? For instance, if average salary for that field in my area is $70,000 is it reasonable to ask for $80,000? I don't know the reimbursement rate and am not sure how much extra my doctor would make on these codes, therefore not sure if I should ask for more money. I just wanted to get some opinions and see if anyone had any advice. Thank you in advance for your time and help. Link to comment Share on other sites More sharing options...
coloradopa Posted April 29, 2014 Share Posted April 29, 2014 I had a question I'm hoping someone can help me with. I am a PA, but also am a Registered Dietitian and planning on becoming a Certified Diabetes Educator. I am trying to get a job in ideally endocrinology or GI, but am also applying to primary care. I know that I can bill as a dietitian through insurance for nutrition education. I have tried to research billable codes and it appears 97802, 97803 and 97804 are medical nutrition therapy billable codes. G0108 appears to be the code for diabetes education. However, it only appears that I can bill for those codes for diabetics and kidney failure patients. Does anyone know if I can bill those codes for medical nutrition therapy for other medical conditions, such as celiac disease, hyperlipidemia etc? Can I bill for medical nutrition therapy if I work for a GI, endocrinologist or primary care doc? Also, in negotiating for salary with the doctor's I do not want to price myself out and ask for too much money but also not ask for too little. I feel that if I can bill those codes as a dietitian, I will make the doctor more money and feel that I should ask for a somewhat higher salary than the average for that field. What would be a reasonable desired salary above the average if I am able to bill for these codes as a dietitian and diabetes educator? $5,000 more or $10,000 more? For instance, if average salary for that field in my area is $70,000 is it reasonable to ask for $80,000? I don't know the reimbursement rate and am not sure how much extra my doctor would make on these codes, therefore not sure if I should ask for more money. I just wanted to get some opinions and see if anyone had any advice. Thank you in advance for your time and help. Not really an expert on dietician codes but looking at them they seem to be tied to certain conditions. The bigger issue and why you wouldn't use them is that they do not have very many RVUs. 97802 has 0.78 RVUs and 97804 has 0.36 RVUs. By comparison established outpatient visits 99212 to 99215 have RVUs that go from 1.29 to 4.2. So if you addressed the medical problems for say CHF and did it in a comprehensive manner including nutrition advice you could bill 5x as much for the same time by using outpatient visit codes. Now having the ability to give that advice and the credentials might be worth more its hard to say. If the practice is using your extra skills and advertising that then it would probably be worth a little more. Link to comment Share on other sites More sharing options...
Guest Paula Posted May 1, 2014 Share Posted May 1, 2014 ^^^^^ I agree with coloradopa. I am a registered dietitian as well and I do not bill anything under the medical nutrition therapy codes. If I spend a comprehensive amount of time with a diabetic patient for example and discuss carb counting and insulin dosing I will bill at a higher code 99214. Same for other medical issues with the nutrition component to it. I am not a CDE and have enough experience and practice to take the exam. I haven't done it yet because it would be yet another certification to keep up with fees and recertifying, plus CDEs are not reimbursable. I bill all nutrition related under office visit codes. Our clinic actually contracts out for an RD once a month to come in. I really don't have a lot of time to do RD stuff anymore and find it not the best use of my time and reimbursement is low. The RD who comes does a fabulous job and is well worth the money we pay him. He bills out every visit and i believe there are codes for everything he does. The physician has to sign off on his charts. This is not to say that becoming a CDE has no value. It does. Just be careful how you are utilized as a CDE/RD. You will want the highest reimbursement which will be billing as a PA. In negotiations you can use your background to your advantage but don't promise more than what you can do realistically. A higher salary may be in order but the primary thing is to not accept a low-ball offer as a PA. Know your value as a PA and then go from there. You would have to negotiate what type of role you would play as a CDE/RD/PA in a practice. Your employers will look at bottom line and what you will bring in to the practice as a PA foremost, then the other areas. I am just starting my new 5-year RD CEU cycle and hoping it is my last. I am at the end of my RD career. If you have any further questions, pm me. Link to comment Share on other sites More sharing options...
Moderator ventana Posted May 1, 2014 Moderator Share Posted May 1, 2014 PA first RD second choose the one that gives bettr pay Link to comment Share on other sites More sharing options...
roombroker03 Posted September 4, 2014 Share Posted September 4, 2014 These conferences are generally situated through arrangements and the medicinal staff regularly have all the time on the planet to react to your condition. Link to comment Share on other sites More sharing options...
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