Accepted Insurance Plans
- Medicare (CKD stages 3-5 and diabetes only)
- Aetna
- BC/BS
- Cigna
- First Choice
- Premera
- Regence
- United Healthcare
Medicare Coverage
Medicare covers MNT (medical nutrition therapy) 100% for Chronic Kidney Disease stages 3-5, post-kidney transplant patients and diabetes. Visits are limited to three hours the first year of referral and two hours per year after. Medicare requires a referral from your doctor. Medicare does not currently cover nutrition therapy for prediabetes, obesity or other diagnoses other than the ones listed above.
Commercial Insurance Coverage and FAQ
What is covered?
Many insurance plans cover Registered Dietitian services, however each plan varies even within the same insurance company. It is important for you to contact your insurance company to find out about your coverage.
What is the difference between “Preventative” and “Medical” coverage?
Preventative Benefits: Preventative benefits are often covered 100%, meaning you do not need to pay a co-pay or pay down your deductible. Preventative coverage applies to nutrition services for patients with:
- High Blood Pressure (Hypertension)
- High Cholesterol (dyslipidemia)
- BMI 25 and over
- Metabolic Syndrome
- Diabetes (Impaired fasting glucose)
- Family history of diabetes or heart disease
Medical Benefits: Medical benefits include nutrition services for specific diagnoses, such as CKD and diabetes. This coverage may include a co-pay and payment toward your deductible if it has not yet been met.
To minimize your cost, I will submit your bill under Preventative Benefits if you meet the criteria.
How many visits does insurance cover?
The number of visits covered varies between plans. Most plans cover 3-10 visits for preventative care.
Do I need a referral?
It depends on the plan. Most insurance companies do not require a referral, however I am required to get documentation of the diagnosis from your doctor. I will contact your doctor to get access to medical records with this documentation.
Out-of-network clients with nutrition coverage:
If I am not an in-network provider for your insurance I will provide a Superbill (detailed receipt) for you to submit to your insurance company for possible reimbursement.
Self-pay Clients:
If you do not have insurance coverage for Registered Dietitian services, you may pay cash or use HSA/FSA funds. If insurance will not cover your visit and you are experiencing financial hardship, please ask about the Sliding Scale Fee.
Fees:
Initial assessment and medical nutrition therapy plan (90 minutes): $246
Follow up consultations and coaching: $172 (60 minutes)
How do I verify if my insurance company will cover my appointments?
Begin by asking your insurance provider:
1. Does my plan cover nutrition counseling?
You can provide these procedure codes:
- 97802 (code for initial appointment)
- 97803 (code for follow up appointments)
2. Does my plan cover preventative nutrition counseling? How many visits?
3. Is medical nutrition therapy is covered and what diagnoses are covered?
4. Is Amy Higbee at Thrive MNT ‘in-network’
You can provide this information if requested:
- Personal NPI (Type 1): 1801519020
- Business NPI (Type 2): 1780450957
- Thrive MNT Tax ID: 93-4610324