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To verify your insurance benefits for nutrition counseling, please call the number on the back of your insurance card and ask them the questions below. Doing this will help ensure you get the most out of your benefits and avoid unwanted financial surprises.
- Do I have benefits for nutritional counseling, CPT codes 97802, 97803, and S9470?
- Do I have any nutrition counseling benefits covered under the preventative care portion of my plan?
- Is a doctor's referral required?
- Is there a limit on the number of visits I am allowed?
- Are there any restricted diagnoses and is Z71.3 covered?
- Do I have a deductible to meet before insurance pays?
- Do I have a co-pay or co-insurance?
- Is Angela Lovell with Nutrition Therapy and Wellness (NPI# 1174999783) a covered provider under my plan?
- If not, what are my out-of network nutrition benefits?
- What is the reference number form this call?
I have listed some information below regarding insurance coverage for nutrition therapy based upon my knowledge and/or experience to date with the companies. Please understand that I absolutely cannot know the details of each plan and that the information below is not a guarantee of coverage. I do not regularly check benefits for clients so it is your responsibility to know what your plan covers and what your portion of the cost is.
Aetna
A doctor's referral is typically not required.
I am considered an "out of network" provider. In many cases, insurance covers nutrition visits in full for both in- and out-network providers. With verification of this, I am happy to submit the claim directly to insurance on your behalf when a credit card is left on file (in case of insurance partial payment or non-payment). If you prefer, you may pay for the visit up front and I can provide you with a superbill which you may submit to your insurance for possible reimbursement.
Detailed information on coverage can be found in Aetna's Policy for Nutritional Counseling.
***Aetna is not currently contracting with Nutrition Therapy and Wellness. If you would like nutrition visits with me covered as "in-network", please contact Aetna and let them know you would like me in their network!
Blue Cross Blue Shield
A doctor's referral is typically not required.
Generally Blue Cross Blue Shield Federal covers 6 nutrition visits annually, with additional visits permitted when medically necessary.
Cigna
A doctor's referral is typically not required.
According to Cigna's Guide to Preventative Health Coverage, 3 wellness/preventative (not related to a specific medical problem) visits are covered at 100%, meaning no cost to you.
***Cigna is not currently contracting with Nutrition Therapy and Wellness. If you would like nutrition visits with me covered as "in-network", please contact Cigna and let them know you would like me in their network!
Medicaid
A doctor's referral is always required. Have your doctor fax it to me at (972) 476-1097.
Nutrition therapy for ages 20 years and under is covered when medically necessary.
Nutrition therapy for ages 21+ is not covered except with authorization for bariatric surgery workup.
I offer reduced rates for clients 21+ with Medicaid coverage - please contact me to discuss this option.
Medicare
Doctor's referral is always required. Have your doctor fax it to me at (972) 476-1097.
Nutrition therapy covered only with a diagnosis of Diabetes or Pre-Dialysis Kidney Disease. They do not cover Pre-Diabetes or any other diagnosis.
Medicare limits the amount of nutrition therapy to 3 hours for the first calendar year you received nutrition therapy, whether nutrition therapy was provided by myself or another dietitian or institution. Medicare limits the amount of nutrition therapy to 2 hours for the second calendar year.
If you have coverage through a medicare advantage plan, additional diagnoses may be covered.
United Healthcare
United Healthcare does not contract with dietitians in private practice.
I am an "out-of-network" provider, meaning you will be responsible for the fee at the time of our appointment and, depending on your plan, a certain amount of that may be paid back to you by your insurance company. Upon request, I can either submit the claim on your behalf or provide you with a form to send in to them for possible reimbursement.
UHC's Coverage Determination Guideline for Preventative Care Services includes information on coverage for wellness/preventative (not related to a specific medical problem) services.
