Will insurance cover my appointment?

For nutrition counseling to be covered, the provider must be in-network with your insurance company, and your plan must have nutrition benefits. I am currently in-network with Aetna, BCBS, and UHC PPO plans. If you have insurance through one of these plans, then the next step is to confirm that your plan has nutrition benefits.

To confirm your plan has nutrition benefits, call the customer service number on the back of your card and ask the following questions:

Do I have nutrition counseling coverage on my insurance plan?

• If the insurance company asks for a CPT code, you can tell them 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.

Will my diagnosis be covered?

• If the representative asks for a diagnosis code (aka ICD 10 code), you can tell them the visit is coded as 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, or 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 and do not 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.

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

How many visits do I have per calendar year?

Does my plan cover telehealth appointments? 

You can choose to pay out of pocket for nutrition counseling.

Standard rates:

Initial appointment (55 minutes) - $210

Follow-up appointment (55 minutes) - $180

Prompt-pay discount (card on file charged the day of the appointment):

Initial appointment (55 minutes) - $160

Follow-up appointment (55 minutes) - $130