Your insurance policy may cover nutrition visits!
Many insurance companies cover nutrition counseling. This is often the case even if you don’t have a medical diagnosis or disease, but would still like nutrition guidance for a variety of reasons.
Nutrition services that are almost always covered under most insurance plans include weight management counseling, disease prevention, and counseling for healthy living and behavior change as a preventative health measure.
Wellness With Laney currently accepts Blue Cross Blue Shield, Harvard Pilgrim Health Care, United Healthcare, Medicare, and Mass General Brigham Health Plan (formerly Allways).
Currently, Laney is licensed in Massachusetts, Texas, Illinois, and Oregon. If you are located in an OPEN (green) state or do not see your insurance plan listed, you may be able to work with Laney through a separate company (Nourish) or submit a superbill to your insurance company for reimbursement. Please reach out to Laney directly for more information.
How to check if your insurance policy will cover our nutrition appointments:
It’s easy! Start by calling the 800 number on your insurance card and ask to speak with a representative.
Next, use the guide below which will walk you through the steps of what to ask the rep in order to see if your plan will cover the cost of nutrition counseling visits.
Insurance FAQ’s and How-To’s
What questions should I ask when calling my insurance company?
Do I have nutritional counseling coverage on my insurance plan?
If the insurance rep asks for a CPT code, please provide them with the following codes: 97802 & 97803. If they say you do not have coverage using those codes, then ask them to check your coverage for the following CPT codes: 99401, 99402, 99403 and 99404.
Will my diagnosis be covered?
If the representative asks for a diagnosis code, tell them the visit is coded using the ICD-10 code: Z71.3
If they do not accept Z71.3, then provide them with Z72.4 and see if that diagnosis is covered on your plan instead
Certain diagnoses ARE covered. If you are overweight, obese, have pre-diabetes, diabetes, hypertension, or high cholesterol you may want to see what your coverage is for these as well. For Medicare, ONLY chronic kidney disease and diabetes are covered. If you have Medicare + another plan (such as Harvard Pilgrim or Blue Cross Blue Shield) and you do NOT have chronic kidney disease or diabetes, then your supplemental plan will be billed, NOT Medicare!
Note that Laney will always code your visit using preventative coding, if possible, in order to maximize the number of visits you receive from your insurance provider.
How many visits do I have per calendar year?
Your insurance rep will let you know how many visits are covered under your plan. Depending on the carrier, number of visits covered can range from 0 to unlimited depending on medical need and benefits included in your specific policy.
Do I need a referral?
Even if preventative services are covered, some plans require a referral from your PCP to be on file prior to our visit. If this is the case, Laney will take care of the referral - you do not need to reach out to your PCP for this, but please tell her if one is required!
Have I met my deductible?
If you have a deductible, Laney will not be able to initially bill your insurance company directly. Therefore, payment of $130.00 is due at the time of your initial visit, and $70.00 is due at each follow up visit.
Laney will provide you will the appropriate documentation to submit to your insurance company to show as a receipt for the services. This will allow you to “pay down” your deductible. Once your deductible has been met and you have nutrition services on your policy, Laney can then directly bill your insurance company.
Do I have a co-pay for nutrition counseling?
For most insurance companies, registered dietitians are considered specialists, therefore your specialist co-pay is applicable and payable at the time of service. You can usually find this information listed right on the front of your insurance card. However, since Laney will try to bill your insurance for preventative counseling, the co-pay is often not applicable. Generally, Laney will wait for the claim to be processed to determine whether or not you have a co-pay, and will then charge the credit card you have on file with us the co-pay amount if necessary.
Note: Verifying your benefits is an important step in getting set up with Laney if you are planning on going through your insurance. YOU are responsible for obtaining this information PRIOR to committing to an appointment with Laney to make sure that both you and Laney are on the same page regarding payment for your visits. Laney is happy to answer any additional questions you have about verifying your benefits, or out-of-pocket payment services.
Additional FAQ’s
I do not see my insurance listed as an accepted provider. Can I still work with Laney?
Laney does not currently participate with Aetna, Cigna, or Tufts. MassHealth does NOT cover nutrition services for individual providers.
If you are out-of-network (possess an insurance plan that Laney does not currently participate with), you will need to pay for your nutrition counseling session at the time of service.
NOTE: if you do have an insurance which considers Laney as out-of-network, Laney cannot submit directly on your behalf, she can only supply you with the appropriate paperwork. Therefore, payment is due at the time for service directly payable to Laney Morse, and you are responsible for submitting the necessary paperwork for reimbursement. Superbills do NOT always guarantee reimbursement - while Laney can provide you with one, there is NO guarantee that your insurance plan will cover it. Please make sure to speak with your representative BEFORE submitting, and understand that you will be responsible for full payment of your services if your policy does not accept the superbill.
Initial visits are $180.00 and each follow-up visit is $80.00. Laney accepts all major credit cards, HSA and FSA.
