Insurance Coverage

INSURANCE COVERAGE FOR NUTRITION COUNSELING

Plan coverage varies widely, so it’s best to speak with a representative from your health insurance provider to confirm your eligibility for nutrition counseling. 
It is your responsibility to understand your insurance coverage and verify your benefits before your initial appointment. Start by calling the phone number on the back of your insurance card and asking the following questions:


1. Does my insurance cover nutrition counseling services?

See if these CPT codes are billable: 97802 and 97803

2. Do I have any nutrition counseling benefits covered under the preventative care portion of my plan?

If the representative asks for a preventive code, please provide them with the following code: Z71.3
(this is a general nutritional counseling code)

3. Do I need a medical diagnosis to cover nutrition counseling? If so, please obtain a diagnosis code from your  medical provider or use some of the following example ICD-10 Codes below. 

Here are some examples:

  • E66.3- Overweight, E66.9- Obesity, E66.01- Morbid obesity

  • E11.65- Diabetes 

  • E78.5- Hyperlipidemia/High Cholesterol

  • I10- Hypertension (high blood pressure)

  • K21.0- GERD

  • K90.0- Celiac Disease

  • 5F0.9- Eating Disorder 

 

4. How many visits do I get per calendar year or benefit year?

5. Is there a co-pay, and/or co-insurance, and/or deductible applied?

6. Is a doctor’s referral required?

7. Obtain the representatives name, date, and call reference # 

Make sure to write this down! 

Questions or having issues? 

Call the office: 732-701-7126

Currently participating with:

Blue Cross Blue Shield

United Healthcare

Aetna

Cigna