Archives for September 8, 2026

 

Every single week, without fail, a dietitian messages me convinced she can bill Medicare for obesity counseling in her private practice.

 

She can’t. Neither can you. And I need you to sit with that for a second before you go verify one more benefit and get burned one more time.

 

The Setup That Gets Everyone

 

Here’s how it always goes. You call Medicare to verify benefits. The rep tells you obesity counseling is covered. You get excited, because why wouldn’t you? You see the client. You submit the claim.

 

It gets denied.

 

And here’s the part that matters: you’re not crazy, and you’re not bad at billing. The rep wasn’t lying to you exactly. They just left out the one detail that changes everything.

 

What’s Actually True

 

 

Medicare Part B does cover Intensive Behavioral Therapy, or IBT, for obesity, for patients with a BMI of 30 or higher. That part is 100% real. It exists. It’s a real benefit with real reimbursement attached.

 

But here’s what the rep didn’t tell you: this benefit can only be billed when it’s delivered incident-to a physician, in a primary care setting.

 

Read that again. Incident-to a physician. Primary care setting.

 

That means you, the dietitian running your own private practice, are not an eligible provider for this specific benefit. It doesn’t matter how airtight your documentation is. It doesn’t matter how qualified you are or how many years you’ve been doing this. The setting and the billing structure disqualify you before you ever submit the claim.

 

So when that rep says “yes, it’s covered,” they’re telling the truth from Medicare’s perspective and giving you exactly zero useful information about your situation. That gap between “technically covered” and “covered for you” is costing dietitians real money every single week.

 

So What Do You Actually Do?

Option one: Partner with a primary care practice. If you’re working under or alongside a physician who bills incident-to, this benefit becomes usable. This is the only path that lets you touch the actual IBT code.

 

Option two: Stop chasing this specific CPT pathway in your solo practice. Lean into what you ARE eligible for. That’s your standard MNT codes, 97802 and 97803, with a proper referral and a covered diagnosis, such as diabetes or CKD.

 

Option three: Bill the G codes. Same payout as 97803, different context, but unlimited visits. This is the one people sleep on.

 

The One Question That Saves You Hours

Don’t trust “it’s covered” at face value. Ever. Ask specifically HOW it’s covered, and whether YOUR provider type qualifies for that exact pathway. This is the same muscle you need to read your EOBs correctly before you outsource anything, and it’s why so many dietitians insist insurance pays nothing when the real problem was never insurance.

 

That one follow-up question saves you hours of chasing a denial that was never going to get paid in the first place. It also protects you from ending up credentialed with five panels and still not making the money you expected, because knowing what’s billable matters just as much as being in-network.

 

And once you’ve got the billing rules straight, don’t skip the paperwork side. Your chart notes need to support medical necessity just as much as your CPT code needs to be right.

 

If this just saved you from a future headache, stick around. I’ve got a whole series of these billing truth bombs coming your way.

 

Want to Stop Guessing at Medicare Rules Altogether?

This is exactly the kind of thing my coaching program exists for, so you’re never one confusing phone call away from a denial you couldn’t have predicted. Inside, we break down exactly what’s billable, what isn’t, and how to build a practice that doesn’t bleed money on claims like this one.

 

👉 Book a call to learn more about working with me

 

And if you’d rather hand the billing headache off entirely, that’s literally what my team at GoodBilling does all day. Let us handle it so you can get back to seeing clients.

 

👉 Get in touch with GoodBilling