You may be wondering, “Does insurance cover nutritionist services?” The answer is: it depends.
At our practice, we find that about 95% of clients have nutrition services covered at least partially by insurance. In this blog, we walk you through exactly how to check your benefits for Medical Nutrition Therapy (MNT), including coverage for both preventative and medical nutrition services.
Does Insurance Cover Nutritionist Services at Plenish Nutrition?
Most likely! Let’s walk through each insurance company.
Aetna Nutrition Coverage
Aetna is typically one of the best insurance plans for preventative nutrition coverage. In our practice, we find that almost 100% of clients with Aetna have preventative nutrition services covered with no deductible and no referral required for up to 10 sessions. Coverage may extend up to 26 sessions with no copay/deductible if a client falls within the overweight or obese BMI category.
While we do not use BMI as a marker of health in our practice, insurance companies may use BMI criteria to determine eligibility for additional preventative nutrition coverage.
Here’s how to verify your benefits with Aetna:
Call the phone number on the back of your insurance card and say –
“Hi, I’m calling because I plan to work with an in-network Aetna nutritionist, and I’d like to confirm my coverage for nutrition counseling.”
Your insurance provider will request the following information:
NPI for the provider you are working with:
Nina: 1518664093
Saundra: 1225871106
From there, ask if you have coverage for CPT codes 97802 (Nutrition Intake) and 97803 (Nutrition Follow Ups)
Next, they will ask if you have an ICD-10 code. We typically bill preventive when possible, using Z71.3 for dietary counseling. However, this often needs to be paired with another diagnosis code, so we commonly pair it with a BMI code.
You can ask whether they would cover Z71.3 with Z68.25 as an example for preventive nutrition counseling.
If your insurance does not cover preventative care, you can check the following medical codes that may apply to you:
Pre-diabetes (R73.03)
Diabetes, Type 2 (E11.9)
High cholesterol (E78.1)
High blood pressure (I10)
Eating Disorder, Anorexia Nervosa (F50.00)
Eating Disorder, Bulimia (F50.2)
Eating Disorder, Binge Eating (F50.81)
Eating Disorder, Other (F50.9)
IBS (K58.9)
IBD, Ulcerative Colitis (K51.90)
IBD, Crohn’s (K50.90)
Celiac Disease (K90.0)
Overweight (E66.3) Obesity (E66.9)*
Once you know sessions are covered, ask the following information:
Do I need prior authorization before scheduling?
How many nutrition visits does my plan cover each year?
Do I have a copay or coinsurance for these sessions?
Do I have a deductible I have to meet before these are covered?
Once you have this information, you can schedule your free call with us here.
Please note coverage is not guaranteed. Insurance companies occasionally provide incorrect information or process claims differently than expected. While we do everything we can to ensure claims are submitted properly, there may be situations where a copay, deductible, or out-of-pocket balance applies.
Cigna Nutrition Coverage
Cigna is great with preventive services. We find that almost 100% of our clients are covered with no deductible and no referral required for preventative services.
Here’s how to verify your benefits with Cigna:
Call the phone number on the back of your card and say –
“Hi, I’m calling because I plan to work with an in-network Cigna nutritionist, and I’d like to confirm my coverage for nutrition counseling.”
Your insurance provider will request the following information:
NPI for the provider you are working with:
Nina: 1518664093
Saundra: 1225871106
From there, ask if you have coverage for CPT codes 97802 (Nutrition Intake) and 97803 (Nutrition Follow Ups)
Next, they will likely ask if you have an ICD-10 code. We typically bill preventive when possible, using Z71.3 for dietary counseling. However, this often needs to be paired with another diagnosis code, so we commonly pair it with a BMI code.
You can ask whether they would cover Z71.3 with Z68.25 as an example for preventive nutrition counseling.
If your insurance does not cover preventative care, you can check the following medical codes that may apply to you:
Pre-diabetes (R73.03)
Diabetes, Type 2 (E11.9)
High cholesterol (E78.1)
High blood pressure (I10)
Eating Disorder, Anorexia Nervosa (F50.00)
Eating Disorder, Bulimia (F50.2)
Eating Disorder, Binge Eating (F50.81)
Eating Disorder, Other (F50.9)
IBS (K58.9)
IBD, Ulcerative Colitis (K51.90)
IBD, Crohn’s (K50.90)
Celiac Disease (K90.0)
Overweight (E66.3) Obesity (E66.9)*
Once you know sessions are covered, ask the following information:
Do I need prior authorization before scheduling?
How many nutrition visits does my plan cover each year?
Do I have a copay or coinsurance for these sessions?
Do I have a deductible I have to meet before these are covered?
Once you have this information, you can schedule your free call with us here.
Please note coverage is not guaranteed. Insurance companies occasionally provide incorrect information or process claims differently than expected. While we do everything we can to ensure claims are submitted properly, there may be situations where a copay, deductible, or out-of-pocket balance applies
Blue Cross BlueShield Nutrition Coverage
Blue Cross Blue Shield coverage varies widely depending on your specific plan. Some plans cover unlimited preventative nutrition sessions with no copay, while others may only cover a limited number of sessions or require a copay or deductible.
We have found that Federal Employee Program (FEP) plans often provide excellent nutrition coverage, with many plans covering unlimited nutrition sessions at 100%.
Here’s how to verify your benefits with Blue Cross Blue Shield:
Call the phone number on the back of your card and say –
“Hi, I’m calling because I plan to work with an in-network Cigna nutritionist, and I’d like to confirm my coverage for nutrition counseling.”
Your insurance provider will request the following information:
NPI for the provider you are working with:
Nina: 1518664093
Saundra: 1225871106
From there, ask if you have coverage for CPT codes 97802 (Nutrition Intake) and 97803 (Nutrition Follow Ups)
Next, they will likely ask if you have an ICD-10 code. We typically bill preventive when possible, using Z71.3 for dietary counseling. However, this often needs to be paired with another diagnosis code, so we commonly pair it with a BMI code.
You can ask whether they would cover Z71.3 with Z68.25 as an example for preventive nutrition counseling.
If your insurance does not cover preventative care, you can check the following medical codes that may apply to you:
Pre-diabetes (R73.03)
Diabetes, Type 2 (E11.9)
High cholesterol (E78.1)
High blood pressure (I10)
Eating Disorder, Anorexia Nervosa (F50.00)
Eating Disorder, Bulimia (F50.2)
Eating Disorder, Binge Eating (F50.81)
Eating Disorder, Other (F50.9)
IBS (K58.9)
IBD, Ulcerative Colitis (K51.90)
IBD, Crohn’s (K50.90)
Celiac Disease (K90.0)
Overweight (E66.3) Obesity (E66.9)*
Once you know sessions are covered, ask the following information:
Do I need prior authorization before scheduling?
How many nutrition visits does my plan cover each year?
Do I have a copay or coinsurance for these sessions?
Do I have a deductible I have to meet before these are covered?
Once you have this information, you can schedule your free call with us here.
Please note coverage is not guaranteed. Insurance companies occasionally provide incorrect information or process claims differently than expected. While we do everything we can to ensure claims are submitted properly, there may be situations where a copay, deductible, or out-of-pocket balance applies
United Healthcare Nutrition Coverage
United Healthcare varies widely with coverage, we haven’t seen much consistency with how they cover nutrition services.
Here’s how to verify your benefits with United Healthcare:
Call the phone number on the back of your insurance card and say –
“Hi, I’m calling because I plan to work with an in-network United nutritionist, and I’d like to confirm my coverage for nutrition counseling.”
Your insurance provider will request the following information:
NPI for the provider you are working with:
Saundra: 1225871106 (Saundra is our only provider in network with United Healthcare)
From there, ask if you have coverage for CPT codes 97802 (Nutrition Intake) and 97803 (Nutrition Follow Ups)
Next, they will likely ask if you have an ICD-10 code. We typically bill preventive when possible, using Z71.3 for dietary counseling. However, this often needs to be paired with another diagnosis code, so we commonly pair it with a BMI code.
You can ask whether they would cover Z71.3 with Z68.25 as an example for preventive nutrition counseling.
If your insurance does not cover preventative care, you can check the following medical codes that may apply to you:
Pre-diabetes (R73.03)
Diabetes, Type 2 (E11.9)
High cholesterol (E78.1)
High blood pressure (I10)
Eating Disorder, Anorexia Nervosa (F50.00)
Eating Disorder, Bulimia (F50.2)
Eating Disorder, Binge Eating (F50.81)
Eating Disorder, Other (F50.9)
IBS (K58.9)
IBD, Ulcerative Colitis (K51.90)
IBD, Crohn’s (K50.90)
Celiac Disease (K90.0)
Overweight (E66.3) Obesity (E66.9)*
Once you know sessions are covered, ask the following information:
Do I need prior authorization before scheduling?
How many nutrition visits does my plan cover each year?
Do I have a copay or coinsurance for these sessions?
Do I have a deductible I have to meet before these are covered?
Once you have this information, you can schedule your free call with us here.
Please note coverage is not guaranteed. Insurance companies occasionally provide incorrect information or process claims differently than expected. While we do everything we can to ensure claims are submitted properly, there may be situations where a copay, deductible, or out-of-pocket balance applies
We hope this blog helped answer the question, “Does insurance cover nutritionist services?” If you still have questions, we are here to help. You can book a free call with our team to discuss your benefits, coverage options, and the best fit for your needs.
Ready to book a free call? We are ready to support you on your nutrition journey. You can book a free call here.
Meet our team here
Note: we are not in network with Medicare or Medicaid. Also, the insurance you use with us must be your primary.
