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Aug 1, 2025

Preventive Services Reminder: Obesity & Nutrition Counseling

Under the Patient Protection and Affordable Care Act (PPACA), coverage is provided for many preventive services without cost share (copayments, deductibles and coinsurance) to patients if provided by in-network providers. 

A reminder that the following are covered as preventive services for Medicare Advantage Plans and Commercial Products:

  • Behavioral counseling for obesity, provided by a qualified primary care provider, for adults with a BMI of 30 or higher 
    • Coverage is based on the time-based HCPCS Level ll G codes when providing time-based evaluation and management (E/M) counseling services related to obesity. 
  • Nutrition counseling provided by a licensed, in-network dietitian or qualified provider
    • Commercial Plans:  For adults with chronic disease and/or cardiovascular disease risk factors, no frequency limits.
    • Medicare Advantage Plans: Nutrition counseling is for people with diabetes, renal disease (but not on dialysis) or after a kidney transplant. 
      • Three hours is covered during the first year under Medicare, and two hours each year after that. Note that physicians can order additional hours beyond the initial coverage if a change in a medical condition requires a change in diet. 

For additional details, please see related policies and billing codes below:

  1. Preventive Services for Commercial Members
  2. Preventive Services for Medicare Advantage Plans
  3. Intensive Behavioral Therapy for Obesity
  4. Nutritional Counseling/Medical Nutrition Therapy