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