Can a PT Bill for Nutrition as Insurance Reimbursement

We sometimes hear this question, can I bill for Nutrition and if so, what code do I put this under?

In some cases, physical therapists (PTs) are not reimbursed by insurance solely for providing nutritional education unless they are licensed or credentialed specifically in nutrition, such as a registered dietitian or nutritionist. Here’s why:

1. In-depth Nutritional Counseling Requirements: While PTs often provide general guidance on nutrition as it relates to physical therapy (e.g., promoting muscle recovery, managing inflammation), most insurance companies require that in-depth nutrition counseling be performed by a credentialed professional such as a registered dietitian. Insurance PTs can still charge for in-depth nutrition services in some states, but it would require cash/private payment.

2. Insurance Billing Codes: PT billing typically covers therapy services like evaluation, therapeutic exercise, and functional training. There are few, if any, PT-specific billing codes for nutrition-related education. Codes that do cover in-depth nutrition counseling usually require a licensed dietitian or nutrition specialist.

Some PTs have used CPT Code 98960 for reimbursement of nutrition services, in combination with other educational tools, for the management of certain conditions (e.g. diabetes, neuropathy, cardiac disease). Understand that the use of this code often requires the PT to be trained in that health condition, certified in the area of education (e.g. Certificate of Nutrition), and/or document the education correctly for optimal reimbursement.

Unfortunately, with all of these variables and the changing insurance landscape, our team at Nutritional Physical Therapy cannot provide you concrete ways to obtain nutritional counseling reimbursement via insurance. 

3. Medicare and State Regulations: Medicare, for example, only covers Medical Nutrition Therapy when provided by a registered dietitian or certain healthcare providers for conditions like diabetes or chronic kidney disease.

All healthcare providers trained, certified, or educated in nutrition can provide general nutritional counseling. Some state regulations may allow PTs to discuss in-depth nutrition within their scope, but they may still not be reimbursed separately for this service. We discuss which states permit what type of counseling within our courses.

Bottom line: In practice, PTs can integrate general nutrition guidance as part of a broader therapy session without billing it as a standalone service. Building nutrition into time periods of relative rest, warmup, or during manual therapy are great ways to still boost patient outcomes and satisfaction. For comprehensive nutritional counseling, cash-pay is likely the best model or referral to an RD.