Medicare FAQ
Medicare has very specific coverage requirements. Medicare ONLY covers nutrition counseling for diabetes, stage 3-5 chronic kidney disease, and 36 months after a renal transplant. Please see full list below. Medicare ONLY reimburses for 3 hours of nutrition counseling the first year of the referral and only 2 hours every year thereafter.
You may be told that ‘obesity’ is a covered service under Medicare. However, this is only if the RD is contracted through a Primary Care Provider (PCP) office and is billing incident to the PCP. We cannot provide this at our office.
We would still love to see you but anything not covered by Medicare would need to be paid out of pocket. Our fees are $150 for the initial one-hour appointment and $120 per hour for follow-ups. We would also need a signed Advanced Beneficiary notice (ABN) before our appointment so that we may bill you.
Medicare Secondary
Marysa Anderson-Cardwell is covered by Medicare Utah, United Healthcare, Cigna, and Blue Cross Blue Shield.
Medicare Advantage plan: If you have a Medicare plan managed by a commercial insurance company like Aetna, Cigna, United Health Care, Humana, or Blue Cross Blue Shield. This plan replaces your Medicare plan. Generally, Advantage plans cover the same stuff as Medicare, so only diabetes and stage 3a, stage 3b, stage 4, and stage 5 non-dialysis CKD are covered.
Again, we would love to still work with you. We try to keep our costs low and also offer package deals if you need several visits with us.
Check out our packages:
The Following Diagnosis Codes are covered by Medicare:
● E10.1 Type 1 diabetes mellitus with ketoacidosis
● E10.2 Type 1 diabetes mellitus with kidney complications
● E10.3 Type 1 diabetes mellitus with ophthalmic complications
● E10.4 Type 1 diabetes mellitus with neurological complications
● E10.5 Type 1 diabetes mellitus with circulatory complications
● E10.6 Type 1 diabetes mellitus with other specified complications
● E10.64 Type 1 diabetes with hypoglycemia
● E10.65 Type 1 diabetes with hyperglycemia
● E10.8 Type 1 diabetes mellitus with unspecified complications
● E10.9 Type 1 diabetes mellitus without complications
● Type 2 diabetes mellitus E11.0
● Type 2 diabetes mellitus with hyperosmolarity
● E11.2 Type 2 diabetes mellitus with kidney complications
● E11.3 Type 2 diabetes mellitus with ophthalmic complications
● E11.4 Type 2 diabetes mellitus with neurological complications
● E11.5 Type 2 diabetes mellitus with circulatory complications
● E11.6 Type 2 diabetes mellitus with other specified complications
● E11.64 Type 2 diabetes with hypoglycemia
● E11.65 Type 2 diabetes with hyperglycemia
● E11.8 Type 2 diabetes mellitus with unspecified complications
● E11.9 Type 2 diabetes mellitus without complications Z79.4 Long term (current) use of insulin
● N18.5 Chronic kidney disease, stage 5
● N18.4 Chronic kidney disease, stage 4
● N18.32 Chronic kidney disease, stage 3b
● N18.31Chronic kidney disease, stage 3a
● Z48.22 Encounter for aftercare following kidney transplant
● Z94.0 Kidney transplant status