Does insurance cover nutritionists and dietitians?
In many cases, nutrition coaching is covered
A nutritionist or dietitian can be a lifeline for people with a chronic disease or those who want to improve their overall health. But with the typical out-of-pocket costs for dietitians ranging from $100 to $250 per visit, these providers can also be expensive.
Most health insurance plans cover a dietitian to some degree, although that coverage varies by insurance plan and may include a copay. You may also need to have a doctor’s referral and choose a dietitian in your insurance’s provider network.
Insurance often covers nutrition counseling, especially for chronic diseases, but the extent varies by plan. Check your plan details to see if you’re covered.
Jump to insightContact your insurer to understand your coverage, find in-network providers and navigate the claims process.
Jump to insightIf your insurance coverage is limited, consider alternatives like local health clinics, government programs, group courses or dietitians offering sliding-scale fees.
Jump to insightTypes of insurance coverage for dietitian and nutritionist services
What your insurance will cover for nutrition counseling depends on your insurance plan. Whether or not you need to obtain a referral for a dietitian’s services and other stipulations on access to care depends on the type of health insurance you have (e.g., a health management organization, or HMO; a preferred provider organization, or PPO, etc.).
Some plans include nutrition services in the summary, but you can always call the listed insurance advocate or advisor to ask questions about what your potential nutrition coverage would be if you were to choose a certain plan.
The documentation required to file an insurance claim for dietitian services depends on how your dietitian bills and whether or not they’re in your insurance’s network.
- In-network providers: These providers bill your insurance directly, providing any necessary documentation to your insurer.
- Out-of-network providers: If your nutritionist is out of network and provides you with a superbill (which includes the reason for the visits and an itemized list of service and costs), you need to file a claim with your insurance directly and await reimbursement.
What to do if your insurance doesn’t cover nutritionists or dietitians
If your insurance doesn’t cover a nutritionist or dietitian and you still want services, you have a few options, says Adrian Hernandez, a registered dietitian. Consider the following:
- Local health clinics: These community organizations sometimes offer low-cost or free nutrition counseling. You may also be able to find lower-cost care at a university clinic where a student nutritionist is being supervised by a professional.
- Government programs: Programs like the Special Supplemental Nutrition Program for Women, Infants, and Children — known as WIC — help women, infants and children by offering education on general wellness. Your local cooperative extension office likely has a nutrition department with classes or workshops for low-income individuals.
- Group courses: Sometimes group nutrition classes are less expensive than individual sessions. If you can’t afford a dietitian, you might consider signing up for group classes or seeing a nutrition coach who’s not a registered dietitian (RD).
- Sliding scales: Some dietitians offer sliding-scale fees or cash payment discounts for those without insurance.
- HSA/FSA: Another option is to use your Health Savings Account (HSA) or Flexible Spending Account (FSA). (For a full list of what you can and cannot use your HSA and FSA funds for, call your plan provider.)
How to determine if your insurance covers nutrition services
To start the process, tell your doctor you’d like to see a dietitian. If the physician is able to provide a valid diagnosis that would benefit from nutrition services, ask for the relevant diagnostic code, suggests registered dietitian Amy Goldsmith.
When you call insurance, tell your insurer what diagnosis (use the diagnostic code if you have it) you plan to see a dietitian for, Goldsmith says. You should also know what the Current Procedural Terminology (CPT) code is — either 97802 for an initial assessment of medical nutrition therapy or 97803 for a follow-up. The insurance agent will tell you whether or not you have coverage.
Don’t forget to ask how many visits are covered and whether you have a copay and/or deductible, Goldsmith notes.
The role of dietitians and nutritionists in the insurance claims process
Dietitians and nutritionists can assist you in navigating the insurance claims process. If a provider is in your insurance network, they can file a claim on behalf of the patient. If the provider is not in your insurer’s network and provides superbills, you can submit those to your insurance provider.
Dietitians and nutritionists can also make sure a patient’s benefits are active by calling the member services line.
FAQ
Can I see a nutritionist or dietitian for preventive care without a medical diagnosis?
Yes, you can see a nutritionist or dietitian for preventive care, but your insurance may not cover it. When you submit an insurance claim for nutrition counseling, you have to attach a diagnosis to it. These can include eating disorders, hypothyroidism, type 2 diabetes and other conditions. Dietitians are not able to diagnose patients; the diagnosis must come from your physician or a therapist, says Amy Goldsmith, a registered dietitian.
Can I use my HSA or FSA to pay for a dietitian or nutritionist?
Yes, you may be able to use your HSA or FSA to pay for a dietitian or nutritionist. However, the provider has to have a way to accept the HSA or FSA card. If they don’t, you can always pay upfront and submit the claim to the administrator of your HSA or FSA later for reimbursement.
What is the difference between a nutritionist and a dietitian?
A registered dietitian (RD) must have a graduate degree, complete a lengthy practicum, pass a national credentialing exam and complete a set number of continuing education hours regularly. All RDs are nutritionists, but not all nutritionists are RDs.