Checking Your Benefits

Insurance coverage for nutrition counseling varies by plan. We can help verify your benefits when possible, but coverage is not guaranteed, and patients are responsible for any portion not paid by insurance.

Before scheduling, you may want to call the member services number listed on the back of your insurance card and ask:

“Does my plan cover medical nutrition therapy or nutrition counseling with a registered dietitian?”

You can also ask whether:

• A referral is required

• Prior authorization is needed

• You have a copay, deductible, or coinsurance

• There is a limit on the number of nutrition visits allowed each year

• Your diagnosis affects your coverage

If your insurance company asks for billing codes, nutrition visits are commonly billed using:

• 97802 – Initial medical nutrition therapy visit

• 97803 – Follow-up medical nutrition therapy visit

A commonly used diagnosis code for nutrition counseling is:

• Z71.3 – Dietary counseling and surveillance

Coverage may be available for conditions such as:

• Overweight or obesity

• Prediabetes or diabetes

• High blood pressure

• High cholesterol

• Chronic kidney disease

• Other medical conditions where nutrition therapy is medically necessary

Coverage varies significantly between insurance plans. Preventive nutrition counseling may be covered differently than nutrition therapy related to a diagnosed medical condition, and some services may be subject to your deductible, copay, or coinsurance.

Medicare Referral Requirements

Medicare requires a referral from a physician for medical nutrition therapy when you have an eligible diagnosis.

Qualifying conditions may include:

• Diabetes

• Chronic kidney disease

• Kidney transplant status, when applicable

Your referral should include the appropriate diagnosis and be submitted before your visit.

Fax referrals to: 844-222-5672