Insurance Information

How to verify insurance coverage?

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How to Verify Your Insurance Benefits for Nutrition Counseling

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Step 1: Call your insurance company

• Use the member services phone number on the back of your insurance card.

Step 2: Ask if preventive nutrition counseling is covered

• Say: “Does my plan cover preventive nutrition counseling or medical nutrition therapy?”

Step 3: Ask about procedure (CPT) codes

• Confirm coverage for:

  • 97802 (initial nutrition appointment)

  • 97803 (follow-up appointments)

• If not covered, ask if they cover 99401–99404 (preventive counseling codes).

Step 4: Ask about diagnostic (ICD-10) codes

• Confirm whether Z71.3 (nutrition counseling) is covered under preventive benefits.

• If not, ask what diagnoses are covered (examples: diabetes, obesity, cardiovascular disease, high blood pressure).

• If a diagnosis is required, note that you may need a doctor’s referral with that code for coverage.

Step 5: Check referral requirements

• Ask: “Do I need a referral from my primary care provider for nutrition counseling to be covered?”

• If yes, ask if the referral must include a specific diagnosis.

Step 6: Ask about telehealth coverage

• Confirm whether telehealth nutrition visits are included, even if other telehealth medical visits are not.

Step 7: Find out the number of covered visits

• Ask: “How many nutrition counseling visits are covered per year? Is there a maximum?”

Step 8: Clarify deductible and co-pay responsibilities

• Ask if visits are covered without meeting your deductible first.

• Confirm whether there is a co-pay for nutrition counseling.

Step 9: Get a reference number

• Always write down the reference number the representative gives you for your call. This protects you if there are any discrepancies later.

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