I am currently credentialed with all major insurance companies, including: HMSA, BCBS, HMAA, Cigna, and United Health. I also accept both HSA and FSA as forms of payment.

That’s perfectly fine if you do not want to use your insurance for nutrition counseling. I also take cash, HSA, FSA, and all major credit cards for out-of-pocket payment.

You should still contact your insurance provider to confirm if (1) you have out-of-network coverage, and (2) if so, do they cover out-of-network nutrition counseling. In some cases insurance companies will still cover the cost of nutrition counseling for out-of-network counseling if it’s for chronic diseases or preventative purposes.

In this instance, you will need to pay with cash upon visitation, and will receive a super-bill to file a claim with your insurance provider.

You can also use your HSA or FSA to pay for nutrition counseling.

Inversely, some insurance providers do not cover nutrition counseling. Therefore, you are required to call your insurance company prior to scheduling your visit to confirm your nutrition visits will be covered.

See FAQ #4, for details on what to ask your insurance provider.

Note: It is your responsibility to call your insurance company PRIOR to your visit to confirm coverage. I try as much as possible to avoid any surprise bills.

That said, here are specific questions to ask your insurance provider.

Question 1: Do I have nutritional counseling coverage on my insurance plan?

• If the insurance company asks for a CPT code please provide them with the following codes 97802 & 97803.

• If they say you do not have coverage using those codes NEXT ask them to check your coverage for the following CPT codes: 99401, 99402, 99403 and 99404.

• I can also bill for S9470 if it is covered on your policy.

Question 2: Will my diagnosis be covered?

• If the representative asks for a diagnosis code (aka ICD 10 code) – please tell them the visit is coded the ICD 10 code: Z71.3

• If they don’t accept Z71.3 then provide them with Z72.4 and see if they will cover that diagnosis instead on your plan.

• If you are overweight, obese, have pre-diabetes, diabetes, hypertension, or high cholesterol you may want to see what your coverage is for these diagnoses as well.

• I always code your visit using preventative coding (if applicable) to maximize the number of visits you receive from your insurance carrier. However, if you ONLY have a medical diagnosis (for example: IBS, and you are not overweight or have CVD risk factors) your insurance may impose a cost-share for your visit either in the form of a deductible, co-pay or co-insurance.

Question 3: How many visits do I have per calendar year?

• Your provider will let you know how many visits they are willing to cover. Depending on the carrier the number of visits vary from 0 to unlimited depending on medical need.

Question 4: Do I have a cost-share for my nutrition visit?

• A cost-share is the amount you will need to pay as required by your particular insurance plan towards your services. A cost-share can be in the form of a deductible, co-pay or co-insurance.

• We will always bill under your insurance policy’s plan under your preventative benefits if your plan allows. With that being said, if you have preventative benefits there if often NO cost share for you associated with the visit. Once again, this is something YOU do want to ask prior to your visit.

• In the event you have a cost-share we will initially bill your insurance company directly. Once we receive the EOB describing your responsibility as the patient, we will bill the credit card on file for the amount noted under ‘patient responsibility.

• For most insurance companies dietitians are considered a specialist. Therefore, your specialist co-pay is applicable and is payable at the time of service. This information is often apparent on the front of your actual insurance card. However, often because we bill your insurance with preventative counseling the co-pay is often not applicable.

• We generally wait for the claim to be processed to determine whether or not you have a co-pay and then charge the credit card you have on file with us the co-pay amount.

Summary of questions to ask to verify your nutrition benefits

• Do I have coverage for nutrition counseling?

• Do I need a referral to see a Registered Dietitian?

• Are my diagnoses covered on my particular plan?

• How many visits per calendar year do I receive?

• Do I have a cost-share for these services?

• Is there an associated cost for me if I choose to have the appointment as a telehealth visit versus in person visit?