Skip to main content
HealthPartners

Coverage criteria policies

Dietitian consultation

These services may or may not be covered by your HealthPartners plan. Please see your plan documents for your specific coverage information. If there is a difference between this general information and your plan documents, your plan documents will be used to determine your coverage.

Administrative Process

Prior authorization is not required for dietitian consultation.

Coverage

Dietitian consultation is generally covered subject to the indications listed below and per your plan documents.

Indications that are covered

  1. Consultations to teach diet modification for a newly diagnosed condition (e.g. diabetes, high blood pressure, pregnancy, renal failure). A consultation is intended for assessment and to establish an individualized program.
  2. Consultations for the management of chronic disease. Nutritional counseling is covered for chronic disease states for which dietary adjustment has a therapeutic role when prescribed by a medical provider and provided by a registered dietitian.
  3. Consultations for dietitian services or evaluations for weight management. See Weight Loss Management coverage policy for further details.
  4. Consultations for weight loss surgery before and after surgery.

Indications that are not covered

Dietitian consultation is not covered for any additional indication, including, but not limited to:

  1. Maintenance Consultation: Once the set goal has been reached, further services will generally not be covered because they are then considered maintenance. .
  2. Weight Reduction Monitoring: Individual visits with a dietitian for weight monitoring as part of weight reduction are not covered, except as described above for weight loss surgery patients.

Definitions

Dietitian consultation is part of a program of care initiated by a medical need to provide dietary assessment and counseling for proper management of an illness, disease process, or disability provided by a Registered Dietitian or Licensed Nutritionist.

Registered Dietitian (RD) -a trained nutrition professional who has met the strict educational and experiential standards set forth by the Commission on Dietetic Registration (CDR) of the Academy of Nutrition and Dietetics (AND).

If available, codes for a procedure, device or diagnosis are listed below for informational purposes only, and do not guarantee member coverage or provider reimbursement. The list may not be all-inclusive.

Codes

Description

97802

Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with

the patient, each 15 minutes

97803

Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the

patient, each 15 minutes

S9470

Nutritional counseling, dietitian visit

CPT Copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

Products

This information is for most, but not all, HealthPartners plans. Please read your plan documents to see if your plan has limits or will not cover some items. If there is a difference between this general information and your plan documents, your plan documents will be used to determine your coverage. These coverage criteria may not apply to Medicare Products if Medicare requires different coverage. For more information regarding Medicare coverage criteria or for a copy of a Medicare coverage policy, contact Member Services at 952-883-7979 or 1-800-233-9645.

Go to

Policy activity

  • 01/01/1994 - Date of origin
  • 03/01/2018 - Effective date
Review date
  • 03/2018
Revision date
  • 04/20/2018

Related content