Does Insurance Pay for a Kidney Dietitian?

If you’ve been told that you have chronic kidney disease (CKD), you might be wondering whether it’s possible to see a dietitian for help—and whether your insurance will pay for it. The good news? In many cases, insurance does cover nutrition counseling, often with zero out-of-pocket cost. In this post, I’ll walk you through how to check your insurance coverage and get started working with me (or your dietitian of choice).

Insurance Coverage for Kidney Dietitians

Seeing a registered dietitian for chronic kidney disease is often covered by insurance. Under the Affordable Care Act, many insurance plans are required to cover preventative services—including medical nutrition therapy (MNT)—at 100% with no co-pay or deductible. That means you may be able to see a dietitian at no cost to you.

Medicare Plans

If you have Medicare or a Medicare Advantage plan and have been diagnosed with CKD or Diabetes, you are entitled to a certain number of hours with a dietitian – at ZERO out of pocket cost:

• First year of seeing a dietitian: Up to three hours of nutrition counseling.
• Subsequent Years: Two hours annually.
• Additional Hours: If your doctor determines more sessions are medically necessary, Medicare will cover them.

Key Requirements:

1. Referral: You need a referral from your physician that includes your CKD diagnosis. Referrals from physician assistants or nurse practitioners are not accepted. Referrals do not need to come from a nephrologist; they can be from any of your doctors.
2. In-Network Providers: You must see a dietitian who accepts Medicare. For Medicare Advantage plans, the dietitian must also be in-network with your specific plan.

Non-Medicare Plans

If you are not a Medicare beneficiary, your plan still likely covers medical nutrition therapy with a dietitian based on requirements from the Affordable Care Act. Some plans will automatically cover nutrition appointments, no matter the diagnosis. Other plans may require that you have a cardiovascular disease risk factor such as high blood pressure or high cholesterol (even if well managed by medication) or being overwight. The best way to know for sure is to call and ask about your plan.

In-Network Insurance Plans

Kidney Foodie is in-network with the following insurers:

• Aetna
• Anthem/Blue Cross Blue Shield (BCBS)
• Cigna
• UnitedHealthcare (UHC)
• Medicare

Lauren sees patients via telehealth in the following states: California, Colorado, Florida, Georgia, Hawaii, Idaho, New York, Massachusetts, Michigan, Oklahoma, Oregon, Pennsylvania, Texas, Utah, USVI, Virginia, Wisconsin, and Washington.

How to Check Your Benefits

Insurance coverage varies by plan, so the best way to determine what your specific plan covers is to call the member services number on the back of your insurance card. Once you’re on the phone with a representative, ask them the following questions (if you want to work with another dietitian, just insert their info into the applicable spots):

Provider Information

• Is Lauren Gleason in-network?
  • NPI: 1174244032
  • Tax ID: 921249258
• If not, is Kidney Foodie listed instead?
  • NPI: 1982317509
  • Tax ID: 921249258

Coverage for Nutrition Counseling

• Do I have coverage for medical nutrition therapy (MNT)? CPT codes to ask about:
  • 97802 (initial nutrition visit)
  • 97803 (follow-up nutrition visits)
• Do I have coverage for preventative nutrition counseling?
  • If yes, ask: Are there specific diagnoses required to qualify (e.g., high blood pressure, prediabetes, high cholesterol, overweight)?

Note: If your plan requires a qualifying diagnosis for coverage, you may need a signed referral or documentation from your doctor. Check your patient portal for visit summaries or a health conditions list. Lab results alone will not work.

• If preventative services are not covered, ask:
  • Which medical conditions are covered for nutrition counseling?
  • Do I need a physician referral?

Important for Medicare Patients: Medicare and Medicare Advantage Plans cover nutrition counseling for Chronic Kidney Disease (CKD) or Diabetes, and a referral is required. If you have been diagnosed with either of those conditions, Medicare will cover at least two hours of nutrition therapy per year with a doctor referral. If you need more time than that, your doctor can send in additional referrals to have more time with your dietitian covered. If you choose to work with me, referrals can be faxed here:

• Kidney Foodie Referral Form: https://kidneyfoodie.com/kidney-foodie-referral-form/
• Fax referrals to: 404-868-8136

Other Key Questions to Ask

• Do I have a deductible to meet before insurance will pay?
• Do I have a co-pay or coinsurance?
• How many nutrition sessions are covered per year (or lifetime)?
• Are telehealth visits covered?

What If My Insurance Doesn’t Cover It?

If your plan doesn’t include coverage (which would be rare!), many dietitians offer self-pay options (myself included). If you have a Health Savings Account or Flexible Savings Account, you can use those funds. Many people find that even a few sessions can make a big difference in managing CKD with confidence.

Ready to Get Started?

Once you have the details from your insurance, you can request your appointment with me directly here.

Still have questions? The BEST way to reach me is to simply reply back to one of my newsletter emails!

How to Find a Renal Dietitian

If you need help finding a renal or kidney dietitian that accepts your insurance and covers your location, I have an in depth article on how to find a kidney dietitian here.