Does Insurance pay for Dietitian Visits?

Dietitian visits may be covered by insurance under Preventative Care.

Read more and find out what your insurance benefits include for Dietitians!

Taking steps towards a healthier life often means seeking the support of a dietitian, especially after bariatric surgery. But let’s face it, understanding the ins and outs of insurance coverage can feel daunting. So, does insurance pay for dietitian visits? Let’s break it down.

Steph, I don’t think my insurance covers any weight loss stuff…

I’ve heard many patients say “I don’t think my insurance will pay for dietitian visits. They didn’t pay for any of my weight loss stuff.” By this, they might mean no surgery coverage or medication coverage.

There are a few things that may be different compared to when you went through your pre-op program appointments. If your surgery was many years ago, the Affordable Care Act has since mandated coverage of some preventative care services such as Medical Nutrition Therapy. You may have more coverage than you did at the time.

There are also some metabolic and bariatric surgery centers that don’t bill for visits with a dietitian. They might roll up all the costs into one package instead.

My tip? Make the phone call and find out what benefits you have instead of assuming you don’t! I’ll share exactly what you want to ask when you call.

Registered Dietitian versus Nutritionist

Because this is another common question, I am going to put this here before we talk about how to find benefit information for Dietitian visits.

A Registered Dietitian has completed all the criteria to take a registration exam including a bachelor’s degree and a year-long internship program. It’s also now a required Master’s Degree to take the registration exam.

They’ve passed their exam and in most cases, hold a medical license in their state. I will come back to licenses…there’s more to say here!

Nutritionist is not a regulated title and could be someone with a PhD in Nutrition, or could be someone with an online certificate. For this reason, insurance companies will only reimburse for a Registered Dietitian and not for a Nutritionist. Some states may reimburse for a Certified Nutrition Specialist (CNS).

Registered Dietitians provide what is called “Medical Nutrition Therapy” and are the best practitioners to effectively provide this therapy.

Understanding Coverage for Dietitian Services

Insurance coverage for dietitian visits varies significantly based on factors like the insurance provider, your health plan, and your reason for seeing a dietitian. However, many insurance plans include coverage for dietitian services—especially when they’re part of a medically necessary treatment plan for specific health conditions, such as obesity, diabetes, or hypertension.

Here are a few scenarios where dietitian visits are often covered:

Preventative Care: many commercial insurance plans DO cover Medical Nutrition Therapy without a co-pay when it is billed under preventative care. At the bottom of this article, I will share the codes you can ask your insurance company to verify coverage. (I called my own and I have unlimited visits covered at 100% under Preventative Care).

Medical Nutrition Therapy (MNT): there is often coverage available for chronic conditions and many commercial insurance companies will provide benefits for MNT for Obesity. Medicare is the most limiting and covered only if there is a diagnosis of Diabetes, Renal Disease, or a kidney transplant.

This is why I advocate for the Medical Nutrition Therapy Act – to increase the list of Chronic Conditions for reimbursement of MNT for Medicare recipients!

Keep in mind, that there are state and plan variations. Someone who has the same insurance carrier as you may have different benefits. Don’t assume, make the phone call!

How to find out your insurance benefits for Dietitian visits

Call your insurance company

Call your insurance’s customer service number, which can be found on the back of your Policy ID card.

Navigate the automated phone system to reach an advocate, and inform them you are calling for Eligibility and Benefits.

Questions to ask:

Do I have nutritional counseling coverage on my insurance plan?

If the insurance company asks for a CPT code (medical service code), provide the following codes 97802, 97803, and S9470.

If not ask for 99401, 99402, 99403, 99404

Follow up by stating that your visits will be billed for preventative care. Otherwise, they may quote you for medical benefits, which may not be covered unless you have a specific diagnosis.

If the representative asks for a diagnosis code (ICD 10 code), use Z71.3

If Z71.3 is not accepted, then provide them with Z72.4, and see if it is covered.

Check to see if there is coverage for the diagnoses listed in your referral. If you are overweight, have obesity, have high blood pressure, high cholesterol, pre-diabetes, or diabetes, you can ask what your coverage is for these diagnoses as well.

Finally, ask how many visits per year are covered.

To wrap it up into bullet points… ​

Get these questions answered:

Do I have coverage for nutrition counseling, when billed under preventative care?

Do I need a referral from my Primary Care Physician to see a Registered Dietitian? (for example, HMO plans) If so you will need a prior authorization or will need to ask your PCP to fax a referral to the Dietitian.

Does my particular plan cover any of my diagnoses?

How many visits per calendar year do I receive?

Do I have a cost-share (co-pay, co-ins, or deductible requirement) for these services? ​

Who and how can work with me for 1:1 Dietitian visits – license laws

I mentioned Registered Dietitians (RD) often hold a medical license in their state. Most states require the RD to have a license in the state that the patient is sitting in at the time of service.

Some states do not have licensure laws which might sound nice because the restriction isn’t there, but license laws provide safety to the public to make sure the provider has the correct education and no reported crimes. Licensure laws are a good thing!

This is limiting, however, for the world of telehealth that we live in. In my case, I can see patients in Kansas or in the states that don’t require the license (Arizona, California, Colorado, Virginia – currently).

If someone lived in Missouri and drove to my office, I could see them because they were in Kansas at the time of service.

As it stands, I can see patients virtually in Kansas, Arizona, California, Colorado or Virgina. I can see patients in-person in my office in Mission, Kansas.

Effective November 8th, 2024 I am in-network with Aetna. Mid-November I will be in-network with United Health Care. BCBS and Cigna are pending.

Yes, I can still see cash-patient clients! Although, this doesn’t change restrictions from license laws.

For more information on booking 1:1 visits with me, click here!

I hope this will help to find out if your insurance covers Dietitian visits. If you call your provider to find out, leave us a comment and let us know how it went!