Rates and Insurance
We are proud to be in network with Aetna, Anthem Blue Cross Blue Shield, Cigna, Medicare, Multiplan, Tricare, United Healthcare, and UMR.
As dietitians, we can bill for Medical Nutrition Therapy using either preventive or medical codes (such as an eating disorder diagnosis or diabetes). If there is an eating disorder diagnosis, you should have unlimited visits under the Mental Health Parity and Addiction Equity Act (MHPAEA).
If we do not have a diagnosis and there is no preventive coverage, we are unable to bill the insurance company for Medical Nutrition Therapy and you can pay our discounted cash pay rates: Initial session $185 | Follow Up $165
You can check your coverage of Medical Nutrition Therapy by calling the Customer Service phone number on the back of your insurance card and asking:
Does my plan have coverage for Medical Nutrition Therapy? Are codes 97802, 97803, and 99404 covered? If you have a specific diagnosis, mention it at this point.
Is there coverage for both preventive and medical diagnosis codes?
Is a referral or preauthorization needed?
Is there a limit on the number of visits per calendar year? Can this be extended, or is it a hard limit?
Is there a deductible that needs to be met?
What is the copay/coinsurance? What is the out-of-pocket max?
What is the reference number for this call?
We are considered a Medical Specialist, so your copay/coinsurance will be higher than what you pay to see your Primary Care Provider. This amount is often listed on the front of your insurance card.
If we are not in network with your insurance company or you do not have a diagnosis and there is no preventive nutrition coverage with your plan, we can provide you with a Superbill to submit to your insurance company. You will pay our cash pay rate of $185 initial/$165 follow up and the insurance company will reimburse you directly.
Cash pay rate: $185 (Initial Intake) | $165 (Follow Up)
Special Rate for Military/Veterans
We are so grateful to our active duty personnel and veterans, and want to thank you for your selfless service to our country. We would like to extend our gratitude by offering a reduced rate of $90/session to all active duty personnel and veterans for nutrition therapy with our team.
Insurances Accepted
If you book an appointment with us, we will check your coverage for you prior to your first appointment, and let you know what your coverage is.
Aetna
Most Aetna policies provide 10 general nutrition visits. After the 10 visits, you will either be charged a higher copay or coinsurance, or we will need a diagnosis (such as an eating disorder diagnosis or a medical diagnosis like diabetes) to continue coverage. We are in network with all plans except HMO, EPO, or marketplace plans.
Anthem BCBS
We are in network with most Anthem BCBS plans except for HMO, EPO, or marketplace plans. There are usually no limits on the number of visits with Anthem plans.
Blue Cross Blue Shield
We are in network with any BCBS PPO plans that have Medical Nutrition Therapy benefits. Please verify this using the script above, or we will check your benefits once you schedule an appointment.
Cigna
We are in network with most Cigna policies except for HMO, EPO, and marketplace plans. 3 visits will be covered at 100% without a diagnosis, and beyond 3 visits, you will need a diagnosis in order for us to bill insurance.
Medicare
We are in network with all Medicare plans only if there is a diagnosis of Diabetes or Chronic Kidney Disease stages 3 or 4 only. Medicare will cover 3 visits at 100%, but additional visits may be covered.
Multiplan
We are in network with Multiplan insurance policies that include Medical Nutrition Therapy benefits. You can check your coverage using the script above, or after you schedule an appointment with us.
Tricare
We are in network with Tricare East plans. If you have Tricare Prime, you will need a referral in order to be seen. Tricare Select plans do not need a referral. If you have Tricare, you must have a provider with the credentials of MD (Medical Doctor), in order for Tricare to cover your appointments.
United Healthcare and UMR
We are in network with most policies except for HMO, EPO, and marketplace plans. Most United Healthcare plans do not have preventive coverage, or if they do, they will charge a discounted rate, which is higher than your copay, but less than our cash pay rate.