At this time Elizabeth Barnett-Boebel can submit claims to BCBS, Aetna, and United Health Care plans for nutritional services. It is your responsibility to verify your insurance benefits and provide the appropriate information to Path.

  • If you have an HMO plan you must get a referral from your Primary Care Doctor before your first appointment. Insurance will deny the claim if there is no doctor referral on file and you will be responsible for the full cost of the appointment.

What questions should I ask when calling my insurance company?

Do I have nutritional counseling coverage on my insurance plan?

  • Ask them if your plan covers CPT codes 97802 & 97803. 

  • If they say you do not have coverage using those codes NEXT ask them to check your coverage for the following CPT codes: 99401, 99402, 99403 and 99404.

Will my diagnosis be covered?

  • Ask if the ICD 10 code: Z71.3 is covered by your plan.

  • If ICD 10 Code Z71.3 is not covered:

- Is this benefit limited to a specific diagnosis or co-morbidity? If so, which ones?  Ex: overweight/obesity, diabetes, family history of diabetes or heart disease. Many Aetna and UHC plans have codes they cover for weight, high cholesterol, high blood pressure, family history of a CVD/diabetes.

- Is there a Physician referral needed? Y/N. (If you have an HMO plan yes, it is needed. Most PPO plans do not require a referral).

How many visits do I have per calendar year?

  • Your carrier will let you know how many visits they are willing to cover. Depending on the carrier the number of visits varies from 0 to unlimited depending on medical need.

  • Is there a Limit to the # of units per visit?  

    • Example; for a first appointment (97804)  do they cover 4, 5, 6 (or more units) 

    • For follow up (97803) do they cover 4 units?

Notes - if you have Aetna they cover 10-26 visits per 12 months, and will cover 4 units (1hr) per visit.

If you have United Health Care - they tend to cover 26 + visits per year, varies based on purpose of visit.

BCBS of TX is often unlimited, but if a private plan or from another state, need to verify benefits.

Make sure to confirm while on the phone.

Have I met my deductible?

  • Most of the time with Z71.3 or other preventable service codes you are not subject to meet your deductible to have nutrition care services covered. However, it is important to verify this.

  • In the event, you have to meet a deductible I will not be able to initially bill your insurance company directly. Therefore, payment of $230 is due at the initial visit and $130 is due at each follow-up visit. Other out of pocket costs may apply and will be directly explained and agreed upon.

  • I will provide you will the appropriate documentation to submit to your insurance company to show receipt of the services. This will allow you to “pay down” your deductible. Once your deductible has been met and you have nutrition services on your policy, I can then directly bill your insurance company.

Do I have a co-pay for nutritional counseling?

VERY IMPORTANT: What is the reference # for this call? 

Note: Date, Time and Person spoke with