Insurance Benefit Resource / FAQ
Did you know that many health insurance companies cover nutritional counseling? This is often the case even if you don’t have an actual diagnosis but still want to come in for nutrition counseling for general health and prevention of a disease.
Check to see if your insurance policy will cover the visits! Start by calling the 1-800 number on the back of your insurance card and ask to speak with a representative.
The information below will walk you through the questions that you need to ask to see if your insurance will cover the cost of nutrition counseling for your visit.
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 primary codes 97802 & 97803. If they say that you do not have coverage using those codes then ask them to check your coverage for the following CPT secondary codes: 99401, 99402, 99403 and 99404.
Will my diagnosis be covered?
If the representative asks for a diagnosis code – please tell them the visit is coded the ICD 10 code: Z71.3 for preventative care. (I always code your visit using preventative coding, when feasible, to maximize the number of visits that will be covered by your insurance.)
If preventative is not covered by your plan, ask your doctor if they can give you a diagnosis such as overweight or obesity and then find out if that is covered.
How many visits do I have per calendar year?
Your carrier will let you know how many visits they are willing to cover.
Have I met my deductible?
In the event that you have a deductible, I will not be able to initially bill your insurance company directly. Therefore, payment is due at the initial visit and at follow ups. I will provide you with the appropriate documentation to submit to your insurance company to show receipt of the services. This will allow you to “pay down” your deductible. Once your deductible has been met and you have nutrition services on your policy, I can then bill your insurance company directly.
Do I have a co-pay for nutritional counseling?
For most insurance companies, I am considered a specialist. Therefore, your specialist co-pay is applicable and is payable at the time of service. This information is often written on the front of your actual insurance card.
Why work with a Registered Dietitian?
Registered Dietitians are food and nutrition experts who apply the science of nutrition into practical solutions for health living, using their clinical expertise to help individuals make personal, positive lifestyle changes.
The “RD” credential may only be used by practitioners who are authorized by the Commission on Dietetic Registration of the American Dietetic Association. Individuals with the RD credential are leaders in the field of dietetics who have fulfilled specific requirements, having earned a least a bachelor’s degree (many RDs also hold advanced degrees) in nutrition and food science, completed an accredited, supervised practice program, passed a rigorous national examination and maintain their skills by meeting the profession’s continuing education requirements for re-certification.
While RDs are sometimes referred to as “nutritionists,” not everyone who uses this title is a “registered dietitian.” In many states anyone may designate themselves a “nutritionist,” regardless of education or training. So do your research when choosing a nutritionist and make sure she is a registered dietitian. Nutrition is not an opinion; it’s a science.