How to Determine Insurance Coverage for Nutrition Services

Use this guide to help you verify your insurance plan’s coverage for nutrition services. The guide outlines key questions to ask your insurance provider about benefits, deductibles, referral requirements, and session limits.

If you’d like, you can submit the information you obtain using the form below.

To confirm if medical nutrition therapy (MNT) is covered by your insurance plan use the number on the back of your card and ask specifically about nutrition counseling and Medical Nutrition Therapy benefits.

If requested: Northern Nutrition Group's National Provider Number (NPI): 1740754472 | Tax ID: 81-4233374

Inquiring about coverage for nutrition counseling and Medical Nutrition Therapy (MNT) provided by a registered dietitian.

Does my plan cover medical nutrition therapy (MNT): CPT codes 97802/97803

Preventive and Specialized Benefits:

Preventive Nutrition Coverage: “Does my plan cover preventive nutrition services under the Affordable Care Act/Healthcare Reform?” Preventive Diagnosis Codes: “What diagnosis codes are considered preventive (e.g., Dietary counseling – Diagnosis Code Z71.3, Obesity – Diagnosis Code E66.9)?”

For those with Diabetes:

Does my plan cover MNT for Diabetes or Diabetes Self-Management Education and Support (DSMES) services? Ask if they use specific billing codes for DSMES (e.g., Medicare often uses CPT codes G0108 for individual sessions and G0109 for group sessions). Is there a limit on the number of DSMES sessions or a cap on the amount covered per year?

Covered diagnoses:

What diagnoses are covered under my policy? Your insurance company may not be forthcoming with this information. You may need to ask about specific diagnosis codes. Examples: Dietary Counseling and Surveillance (Z71.3), Eating Disorders (F50.0 - F50.9), Diabetes (Type 2: E11.9, Type 1: E10.9, Celiac Disease (K90.0), IBS (K58.0), Hypertension (I10), Chronic Kidney Disease (N18.9), Obesity (E66.9), and Malnutrition (E46). To find your specific diagnosis code, please contact your provider.

Financial Considerations:

Deductibles: "Will my services be applied to my deductible" or “Do I have a deductible to meet first? If yes, how much?” Co-Payments/Coinsurance: “Do I have a co-pay or coinsurance amount for these services? If so, what is it?” Session Limits: “Is there a limit on the number of visits, hours or the total dollar amount covered per year?” Frequency and Duration: “Are there any limits on the frequency or duration of sessions (e.g., one session per month)?

Authorization & Referral Requirements:

Physician Referral: “Do I need a physician referral to access these services?” *If yes, contact your doctor’s office to send a referral with the correct diagnosis to (406) 551-1420. Prior Authorization: “Do I need prior authorization, and if so, what is the process?”

Out-of-State Policyholders

If your policy is not a Montana-based policy, consider asking: "Are there any state-specific restrictions on my coverage?" "Do I need a pre-approval waiver for out-of-state care?" or "I am a student attending school in Montana, but my insurance policy is from another state. Are there any coverage restrictions or any additional authorization requirements I should be aware of?" "My provider is physically located in another state but is licensed in the state where I am receiving services. Are there any coverage restrictions or authorization requirements for this situation?" "Does my policy cover telehealth services from an out-of-state provider?"

Representative Name and Reference Number

If you’d like to send us the information you obtained from your insurance provider, please complete the rest of the form below before submitting.

Name

First Name

Last Name

Phone

(###)

###

####

Insurance Company

ID Number

Group Number

Additional Information