Billing Medicaid For Nutritional Counseling

By July 25, 2018 Healthcare Law
Billing Medicaid For Nutritional Counseling
Nutritional Counseling Program
The nutritionist’s goals are to enable health care providers to treat obesity as a disease and bill accordingly. Ul mately, this will help reduce obesity rates in South Carolina and improve health outcomes.
The program is for:

  • Adults with a body mass index (BMI) of 30 or greater who are commi ed to losing weight through diet and exercise.
  • Children with a BMI at the 95th percen le or greater will con nue to be covered through the Medicaid Early Periodic Screening Diagnosis and Tes ng program.The Nutritional Counseling Program includes:
  • Six visits with a physician, physician assistant, and/or nurse prac oner and
  • Six visits with a licensed die an.Patients must be referred by their health care provider to a licensed dietitian.
    If you are already referring your Medicaid pa ents to a local licensed die an, that die an is eligible to provide nutri onal counseling services. If you do not have access to a local licensed die an, one can be provided to you through a partnership with the Department of Health and Environmental Control.

Note for Pediatricians:

  • Reimbursement amount is $13.91 per 15 minute session ($27.82 daily max), for licensed die ans and $22.76 per 15 minute session ($45.52 daily max) for pediatricians.
  • Nutri onal counseling units billed for peds are based on 15 minute me unit session and are limited to two per day with a maximum of 12 in a year.
  • Pediatricians must bill the appropriate level of Evalua on and Management (E&M) service codes (99201-99215) if obesity is diagnosed during the EPSDT visit.

Billing Medicaid For Nutritional Counseling

Ansari Law Firm

Author Ansari Law Firm

More posts by Ansari Law Firm