Insurance coverage for nutrition counseling

Did you know that you can use your insurance benefits to cover nutrition counseling often at no cost to the client?

The most important thing to know is that you must call your insurance company to verify your specific benefits. 

I am currently in network with: 

  • Aetna
  • Cigna
  • United Healthcare (coming soon)
  • Medicare (covers CKD, kidney transplant post-care and diabetes)

I share everything you need to know below! Please note this is general guidance. Reach out with any questions.

The service delivered is called medical nutrition therapy, or MNT. “Medical nutrition therapy (MNT) is an evidence-based process aiming to treat or manage a disease through nutrition.” It includes:

  • Nutrition diagnosis
  • Diet modifications
  • Nutrition therapy
  • Nutrition counseling and education
  • Monitoring and evaluation

I find the term “medical nutrition therapy” to be a bit stuffy therefore, you will see me refer to my process as “nutrition counseling” when speaking to clients but rest assured that I am delivering medical nutrition therapy.

Insurance companies categorize medical nutrition therapy into two areas: preventive coverage and medical coverage. 

Preventive coverage for nutrition counseling 

Preventive care is nutrition counseling applied to patients with:

  • Cardiovascular disease risk (high cholesterol, high blood pressure)
  • BMI 25 and over; or under 19. 
  • Diabetes
  • Family history of heart disease or diabetes

These preventive benefits are covered typically 100%. This means no co-pay, no deductible and no co-insurance. 

When I submit claims, I ALWAYS bill under preventive coverage where applicable to maximize this benefit and minimize cost to you. 

Medical coverage for nutrition counseling

If you don’t meet the criteria for preventive coverage, your plan may have MNT under medical coverage. The cost of this will vary widely depending on your plan but there is typically a co-pay and perhaps a deductible to meet. 

It depends on the plan! Many plans cover at least 10 visits under preventive coverage. Other plans cover unlimited visits. Most plans cover at least 3 visits. 

It depends on the plan. When nutrition counseling is covered under medical coverage, a referral is required.  All Medicare beneficiaries seeking medical nutrition therapy from a dietitian need a referral within the calendar year of the service. I reserve the right to ask you/your physician for a referral if I think it is necessary regardless of what your insurance company says. 

MNT Services are covered under Medicare Part B or Medicare Advantage Plans (Part C).

Medicare beneficiaries are eligible for MNT services by a dietitian if they have one or more of the following conditions:

  • Diabetes
  • Chronic Kidney Disease (stages 3a-5)
  • Have had a kidney transplant within the last 36 months. 

Medicare does not cover nutrition services delivered by a registered dietitian for obesity or prediabetes or any other diagnoses except those above at this time. 

Medicare will require a referral from an MD with the diagnosis.

In the first year, 12 units (3 hours) are covered. This is broken up into an initial session and follow up(s).

If your doctor and dietitian decide that you can benefit from additional visits because something has changed, then you are eligible for additional visits. 

If I am an out of network provider then you can opt for self pay and I can provide you with a superbill to submit for reimbursement. My hourly rate is $200 (as of April 2024). If I am in network with your insurance and you would like to pay out of pocket, then there may be a form to complete.

If you have Medicare and would like to see me for a non-covered service, then you complete a form called an ABN. 

Husky, or CT Medicaid, only covers nutrition services in a facility like a hospital or clinic. This means dietitians in private practice like me unfortunately cannot accept Husky (at the time of this article).

Call the member services number on the back of your insurance card and ask. Please note that is my policy that the patient verify their benefits.  

Use this Insurance Verification Script when you call  to get the exact information you need.

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