Rates and Health Insurance

Kylee Pedrosa Nutrition & Wellness Accepts:

Medicare-Referral required; please read coverage details below
Aetna-Physician order/referral required; please read coverage details below
Independence Blue Cross
United Health Care
Blue Cross Blue Shield

Payment:

Cash, check, credit/debit cards, HSA & FSA cards accepted.
A credit/debit card on file is required to secure appointments.

Coverage varies greatly between plans. Please scroll down for help determining what your plan covers. If insurance declines to cover your visit(s) for any reason, you are responsible for the full amount billed.

If we are out of network with your insurance, sessions may still be covered. Upon request, we can either send a claim to your insurance on your behalf or provide you with a superbill to submit yourself for possible reimbursement. Payment is due from you at the time of service.

Service	Standard Rates (billed to insurance)	When Paid at Time of Service
Initial Assessment (85 minutes standard)*	$250	$180
Follow-Up-(55 minutes)	$150	$110
Accountability Subscription	-	$50/month
10-Day Continuous Glucose Monitor Subscription	-	$250

*Aetna only covers up to 1 hour for all appointments. Clients preferring the usual longer initial appointment of 85 minutes may pay $60 out of pocket for the added time not covered by Aetna.

Before your visit, call your insurance company and ask:

Do I have coverage for Nutrition Counseling or Medical Nutrition Therapy? (insurance codes 97802 and 97803)
Are there restrictions on which diagnoses are covered?
Is Z71.3 (dietary counseling and surveillance) covered, or is a medical diagnosis required*?
Do I need a referral or preauthorization from my doctor?
Is nutritional counseling covered when provided via telehealth?
How many visits are allowed per year?
Do I have a deductible to meet before insurance pays? If so, is the deductible waived for preventive nutrition therapy??
Will I have a copay or coinsurance?
Is Kylee Pedrosa, MS, RD, CDCES (NPI 1457918617) covered under my plan? If not, what are my out-of-network nutrition benefits?
Write down the date and reference number for your call.

Confirming your insurance coverage first will help ensure you get the most out of your benefits and avoid financial surprises!

*If a medical diagnosis is required, have your doctor fax recent visit notes and your diagnosis list to us at 267-482-9467

Call Insurance

Important Information About Each Insurance Company:

See information below regarding insurance coverage for nutrition therapy based upon our knowledge and/or experience to date with each insurance company we are network with. Please understand that we cannot know the exact details of each plan and that the information below is not a guarantee of coverage. We do not regularly check benefits for clients therefore it is your responsibility to know what your plan covers and what is your portion of the cost of services provided.