Health Insurance Coverage
I am a preferred provider for BCBS, Cigna and Aetna and will bill directly for you if you have coverage. However it is your responsibility to call your insurance company and ask if nutrition is covered as well as acceptable conditions for CPT code 97803. Some insurance plans impose treatment restrictions such as limiting the number of sessions and/or the allowable diagnoses. It is your responsibility to check with your insurance company.
BCBS of Massachusetts: Almost every BCBS of Massachusetts plan covers nutrition consultations. If you have a PPO you do not need a referral.
If you have an HMO you will need a referral from your PCP. You can provide your PCPs office with my National Provider Identifier number (NPI) which is 1538197405. (Some medical groups such as Harvard Vanguard will not offer referrals outside of their network.)
Cigna and Aetna: A few Cigna and Aetna plans cover nutrition. Check your plan for coverage details.
You are financially responsible for co-payments and deductibles imposed by your insurance carrier.
HPHC, Tufts, GIC, United, others These are out of network for me. I will provide you with a Superbill you can submit for out of network coverage.
Fee for Service Cost:
For those who are paying out of pocket the fee for service price is as follows:
- Nutrition sessions are billed at $150/hour. $37.50 for each 15 minutes
- Initial sessions usually last 60 – 90 minutes ($150-$215)
- Follow up sessions are from typically 30 – 60 mins ($75-$150)
Included in above out of pocket cost are email followups post session. (because there are always questions that arise and I don’t want people to be stuck or confused about our plan of action)
Flex spending HSA Cards:
Your pre-tax health Flex Spending Account (FSA) can be used to pay for nutrition sessions and copays. If your employer issued a an FSA Debit card we take those for your convenience. If you do not have a flex spending card we will provide you with a Superbill you can submit to your plan administrator.