Guide to inquiring about insurance coverage for Nutrition and/or Diabetic Counseling Services
Please call your insurance company for specific information on your coverage benefits. You can find the customer service number on the back of your insurance card.
Important questions to ask your insurance company:
- Is nutritional and/or diabetic counseling covered under my medical plan, specifically procedure codes (G0108, 97802 & 97803) received in a hospital outpatient setting?
- Is nutrition counseling covered if I have certain diagnosis (from the list above)?
- How many sessions per year are covered?
- If nutrition counseling is covered, do I have a co-pay or co-insurance per session?
- What is my deductible and how much is remaining for this year?
- Is Winona Health Services an in-network provider?
- If not what are my out-of-network benefits?
- Is a referral or preauthorization from my primary care physician required?
- If yes, please call Winona Health’s business office at 507.457.4579 option 4 to reach our pre-authorization and referral specialist to assist you with this.
- If your plan does not cover nutrition counseling, or you do not meet your plan’s qualifications for coverage, you have the option of paying out of pocket. Out-of-pocket prices are listed on the back.
For your benefit, we recommend that you obtain a reference number for your call.
|G0108||Diabetes Education Management Training||$71 for 30 minutes
$142 for 60 minutes
|97802||Medical Nutritional Initial Assessment (typically 60 minutes)||$132|
|97803||Medical Nutritional Follow-Up (typically 30 minutes)||$66 for 30 minutes
$99 for 45 minutes
$132 for 60 minutes
Medicare Part B Insurance
Medicare covers medical nutrition therapy services and certain related services. It will reimburse you for limited nutrition services, such as counseling for patients with diabetes or kidney disease only. The first year you are diagnosed, Medicare covers three hours of one-on-one counseling services. For each subsequent year, Medicare covers two hours of one-on-one counseling services.
Counseling for other conditions or receiving additional hour of counseling do not meet Medicare’s medical necessity requirements, so you will be asked to sign an Advance Beneficiary Notice (ABN) informing you of the cost and the reason for non-coverage.
To schedule your appointment with a Winona Health nutrition or diabetes counselor please call: 507.457.4521