With so much talk of nutrition online, you might be wondering, are dietitians covered by insurance? 

Dietitians are credentialed nutrition experts who can offer personalized guidance and support for a wide range of health concerns, from managing chronic conditions to improving your relationship with food.  

In this blog, we’ll break down what you need to know about insurance coverage for dietitians, including which plans typically offer benefits, which conditions are commonly covered, when you might need a referral, and what your options are if you choose to self-pay.

Interested in working with an eating disorder dietitian at Kristie Tovar Nutrition? Use this link to get your insurance benefits checked today. It only takes a couple of minutes!

Are Dietitians Covered By Insurance? 

In many cases, yes- dietitians are covered by insurance. Nutrition counseling is often included under preventive health services, which are covered by the Affordable Care Act. 

However, the extent of coverage can vary depending on your insurance provider, your plan details, and whether a specific medical diagnosis is involved. 

It is also helpful to understand the difference between nutrition counseling and Medical Nutrition Therapy (MNT). While both are provided by dietitians, MNT involves more in-depth, tailored support for managing specific medical conditions (like diabetes, kidney disease, or eating disorders) based on an official diagnosis. 

Nutrition counseling, on the other hand, may focus on general wellness, intuitive eating, or improving food habits without a clinical diagnosis. 

These services are billed differently, and we will go over all the specifics so you know what to expect. 

What Insurance Plans Typically Cover Nutrition Counseling? 

At Kristie Tovar Nutrition, we accept the following insurance plans:

• Blue Shield of CA
• Blue Cross/Blue Shield
• Anthem
• United Healthcare
• AETNA
• Healthnet (PPO plans)

It’s important to keep in mind that coverage depends on two overarching factors:

1. Whether your insurance plan includes benefits for nutrition services.
2. Whether the dietitian you want to work with is an in-network provider for your plan.

Since each insurance plan can vary, we always recommend verifying your benefits in advance. A step-by-step guide is included in this blog!

Which Conditions Are Often Covered? 

As mentioned earlier, some insurance plans require a medical diagnosis in order to cover nutrition counseling or MNT. These diagnoses typically qualify for coverage under most insurance plans:

• Diabetes (Type 1, Type 2, gestational, prediabetes)
• Chronic kidney disease
• Obesity (especially when accompanied by comorbidities)
• Cardiovascular conditions such as heart disease, high cholesterol, and hypertension
• Eating disorders and GI conditions
• Food allergies

These conditions are commonly recognized by insurance companies as requiring nutrition intervention, which means services provided by a dietitian are more likely to be reimbursed. 

Good news: If you don’t have a qualifying diagnosis, many insurance plans still cover general nutrition counseling as a preventive service. 

How to Find Out If Your Insurance Covers a Dietitian 

Now let’s get into the logistics of finding out the answer to our question: Are dietitians covered by insurance? Here’s a step-by-step guide to help you check your benefits:

*Note: If you want to work with Kristie Tovar Nutrition, you can skip these steps. We verify your benefits for you. Just fill out this form and we’ll be in touch. 

Step 1: Contact Your Insurance Provider

Call the member services number on the back of your insurance card (usually a toll-free 800 number). You can also log in to your insurer’s member portal online to view your plan details.

Step 2: Ask About Nutrition Counseling and CPT Codes

Tell the representative you want to know whether your plan covers nutrition counseling or MNT with a dietitian. 

Be sure to ask about these CPT (Current Procedural Terminology) codes. They’re used for billing nutrition services and help determine how many sessions your plan will cover:

• 97802- Initial nutrition assessment
• 97803- Follow-up nutrition sessions

If you have a medical diagnosis like high cholesterol, diabetes, or an eating disorder, ask if it qualifies for coverage. They can typically look up the associated ICD-10 code, or you can find it in your online health chart. If you do not have a medical diagnosis, you can ask about preventative nutrition, which is represented by the ICD-10 code Z71.3.

Step 3: Ask About Referrals or Pre-Authorization

With a PPO insurance plan, you generally don’t need a referral from your primary care provider. However, you should always ask if a referral or pre-authorization is required for reimbursement. 

Other helpful questions to ask:

• How many dietitian visits are covered per year?
• When do my benefits reset?
• Are telehealth appointments covered?

At Kristie Tovar Nutrition, you can skip these steps. We verify your insurance benefits for you. Click this link to get started!

Do You Need a Referral to See a Dietitian? 

In California, a referral from a licensed healthcare provider is required for a dietitian to provide dietary advice, treatment, or MNT. 

This referral must include a written prescription that outlines the patient’s diagnosis. 

In other states, you may not need a referral- laws vary by location. However, regardless of state law, some insurance plans still require a referral or prior authorization to approve nutrition counseling services. 

That’s why it’s important to check both your state’s regulations and your insurance benefits.

At Kristie Tovar Nutrition, we help simplify this step by providing you with a referral form you can give directly to your doctor. Our goal is to make accessing care as seamless as possible. 

Can You See a Dietitian Out-of-Network? 

Yes, but it may cost more. When a dietitian is in-network, they’ve agreed to a discounted rate with your insurance company. Out-of-network dietitians don’t have this agreement, which often means higher out-of-pocket costs.

Some insurance plans do cover out-of-network services, but typically at a lower rate. You’ll usually pay upfront, then submit a superbill (an itemized receipt with diagnosis and procedure codes) for possible reimbursement, though it’s not guaranteed.

If you’re paying out of pocket, rates will vary based on location and the dietitian’s experience.

Summary: Are Dietitians Covered By Insurance? 

Understanding if and how dietitian services are covered by insurance can feel overwhelming, but it’s an important step toward getting the support you need. 

Many dietitians are covered by insurance, but coverage depends on your plan, the type of service, and sometimes a medical diagnosis or referral. 

At Kristie Tovar Nutrition, we accept insurance, and we help make this process easier by verifying your insurance benefits for you. Use this link to get your insurance benefits checked today!