Health Insurance for Nutrition Counseling Services

I am currently in network with Anthem Blue Cross Blue Shield, Cigna, and Friday Heath Plans.

If you plan on using your health insurance for nutrition counseling, you will need to verify your benefits before booking your initial appointment to ensure nutrition counseling is covered under your plan.

The Q&A below will help guide you through the process of verifying your health insurance benefits. If you have any questions throughout this process please feel free to contact me here

● What should I ask my insurance provider when I am verifying my benefits?
○ Start by calling the 800 number on the back of your insurance card and ask to speak with a representative.
○ Ask the representative if you have coverage for the following CPT codes: 97802 and 97803
■ If they say you don’t have coverage with those codes, ask them to check your coverage for: 99401, 99402, 99403, or 99404.
○ Next, ask if your policy covers nutrition counseling for the following ICD 10 code Z71.3
■ If they don’t accept Z71.3, provide them with Z72.4
■ If they say no, ask them what diagnosis codes are covered.
● How many visits do I have per calendar year?
○ Your insurance carrier will let you know how many visits they cover. The amount of visits available varies depending on the carrier.

● How do I know if I’ve met my deductible?
○ If you have a deductible, you will not be able to bill your insurance company directly until your deductible has been met. You are required to pay out of pocket for your visits.
○ These payments will count towards your deductible. Once your deductible has been met, you will be able to start billing your insurance company directly if nutrition services are covered under your policy.

● Does insurance cover telehealth visits?
○ Many insurance carriers now cover telehealth services. When you verify your insurance benefits with your carrier, be sure to ask them if your plan covers telehealth, and if there is a co-pay

● Do I have a co-pay for nutritional counseling?
○ For most insurance companies, I am considered a specialist. If that’s the case with your insurance, the specialist co-pay is applicable at the time of your visit. If your insurance company allows you to bill for preventive nutrition counseling, the co-pay is often not applicable.