Did you know that many health insurance companies cover nutritional counseling?

95% of Miriam Boutte Nutrition patients pay $0 out of pocket. If you would like to learn about your coverage, please call the 800 phone number on the back of your insurance card and ask to speak with a representative. The information below will walk you through the steps to see if your insurance will cover the cost of nutrition counseling for your visit.

What insurance companies do we participate with?

I am a preferred provider (in-network) with the following insurance companies:

Aetna
Cigna
UnitedHealthcare (UHC)
United Medical Resources (UMR)
Blue Cross Blue Shield (BCBS/Anthem)
Medicare*
*Medicare covers Medical Nutrition Therapy only for Type 1 or Type 2 Diabetes and non-dialysis kidney disease (stages 3–5). 


Out-of-Network Coverage & Superbills

If your insurance provider is not listed above, you may still be eligible for reimbursement through out-of-network benefits. I can provide a superbill after your session, which is a detailed receipt that you can submit to your insurance company for possible partial or full reimbursement. Coverage varies by plan, so I recommend checking with your provider to understand your out-of-network benefits.

What questions should I ask when calling my insurance company?

Do I have nutritional counseling coverage on my insurance plan?

If the insurance company asks for a CPT code, please provide them with the codes 97802 & 97803. If they say you do not have coverage using those codes, NEXT ask them to check your coverage for the CPT codes 99401, 99402, 99403, and 99404.

Will my diagnosis be covered?

If the representative asks for a diagnosis code – please tell them the visit is coded with the ICD 10 code: Z71.3. I always code your visit using preventative coding to maximize the nutrition visits you receive from your insurance carrier.

How many visits do I have per calendar year?

The representative will let you know how many visits they are willing to cover. Depending on your insurance, the number of visits can vary from 0 to unlimited, depending on medical need.

Have I met my deductible?

Deductible requirements vary by insurance plan and are not always known until a claim has been processed. In some cases, nutrition visits may be covered before a deductible is met; in other cases, visits may apply toward your deductible.

If deductible responsibility is identified after a claim is processed, you will not be charged for sessions that already occurred before this determination was made. We will review your options with you before any future appointments, including whether to continue using insurance or transition to self-pay services.

If a deductible applies and is not paid, we are unable to continue billing insurance for future services. To remain compliant with insurance billing requirements, insurance claims must be withdrawn or not submitted, and services will transition to self-pay.


Do I have a co-pay for nutritional counseling?

Copay requirements depend on your insurance plan and how services are billed.
When nutrition services are billed as preventive, many insurance plans do not require a copay. If services are billed as medical, a specialist copay may apply based on your insurance benefits.

Specialist copay amounts, if applicable, are often listed on the front of your insurance card or can be confirmed by contacting your insurance provider.

Billing type is determined by clinical documentation, medical necessity, and insurance guidelines and does not guarantee coverage.


Do you still have questions? Email: info@miriambouttenutrition.com