How to check Out-Of-Network Insurance Benefits for Nutrition Counseling

● Call the member services number on the back of your insurance card and ask: Does my plan cover out-of-network outpatient nutrition counseling? Give them codes: 97802 and 97803

a. If yes, how many sessions are allowed?

● Ask: Does my plan only cover visits that are “medically necessary” like eating disorders or does it also cover preventive services? (code: Z71.3)

a. (If applicable to you) If it does cover eating disorders, which eating disorders and

are there any limitations around the number of visits per year?

● Ask: How much per session does my plan cover?

● Ask: Do I have a deductible to meet first? If yes, how much is my deductible? How much of the deductible have I met?

● Ask: Do I need a physician referral?

● Record the representative’s name and a reference # when checking your benefits. This information will be necessary if you ever need to dispute a rejected claim.