There are reasons why nutritionists aren’t covered by insurance. It is an important distinction, let’s find out why.
Nutritionist Vs. Dietitian:
A Registered Dietitian has met the minimum degree requirements from an accredited university and must take a registration exam. This education includes nutrition and dietetic coursework, supervised practice, and a credentialing exam. The minimum requirement was a bachelor’s degree, but new graduates must have a Master’s degree.
A Nutritionist is a person who studies nutrition and/or provides education or counseling on nutrition principles. This may not include a degree from an accredited program.
There are no minimum coursework or practice requirements to become a nutritionist.
There is a good reason why insurance should not have nutritionists covered by insurance. There is no standard education or credentialing to become a nutritionist.
The name nutritionist and dietitian are sometimes used interchangeably. When it comes to insurance coverage, insurance companies cover professionals who have credentials which are registered dietitians.
Does insurance cover a dietitian?
Yes! There are many dietitians that take insurance. There are many ways to find a dietitian that takes insurance. Many times nutrition counseling is covered by the Affordable Care Act and there may be no charge to you.
Ask friends and family if they know one.
Call your insurance and ask who is in the network
Ask your health care providers who they recommended
Many dietitians have social media accounts or websites with information on them about insurance
Does my insurance cover a dietitian?
If you are interested to know if your insurance covers a dietitian here is a script I give to patients to call and verify their benefits.
Call your insurance company. The member service number should be on the back of your card.
Ask if you have nutrition counseling benefits.
Ask if Amy Beney/Nutrition Insights PLLC is an in-network provider.
The CPT codes that are used are 97802/97803.
If they say you do not have coverage for 97802 or 97803, then ask if you have coverage for 99401, 99402, 99403, and/or 99404. I can also bill using a code s94770
Does my insurance plan have preventative nutrition counseling benefits?
The ICD 10 code for preventative services is Z71.3 and or Z72.4
If you have a diagnosis of diabetes, prediabetes, obesity, BMI >25, kidney (renal) disease, hypertension, high cholesterol, family history of cardiovascular disease, these codes may be covered and there may be no charge to you.
If you have diabetes, try the ICD 10 code E11.9.
Ask if there is any patient responsibility toward the bill (co-pay or deductible)?
Ask for a reference number for the phone call.
Preventative insurance coverage.
There is a good chance that your insurance will cover a dietitian it if you have a health concern that is nutrition related. Many diseases are affected by the foods we eat. This is often described as a medical necessity.
Insurance based nutrition coverage has been due to the Affordable Care Act.
How to find a nutritionist covered by insurance?
If you are still interested in seeing if a nutritionist is covered by insurance,
see the above steps. Call your insurance company and see if they cover a nutritionist or if they cover a Registered Dietitian. If you aren’t sure, just ask.
Although nutritionist and dietitian jobs may be used interchangeably, the credentialing process that a dietitian must achieve is what sets them aside and qualifies them to be in network with insurance companies.
Definitions of Terms List. Commission of Dietetic Registration. Accessed April 13, 2023. Https//www.cdrnet.org/defintions