State insurance laws that require MNT or nutrition counseling
The short answer19 states have an insurance law we could read that makes fully insured plans cover nutrition services: Colorado, Connecticut, Florida, Illinois, Kansas, Louisiana, Maryland, Massachusetts, Minnesota, Nebraska, Nevada, New Hampshire, Rhode Island, South Dakota, Texas, Vermont, Virginia, Washington and Wyoming. Most tie it to diabetes self-management education; Louisiana covers nutrition counseling in pregnancy. 15 name a dietitian. Self-funded employer plans follow federal rules, so the law may not reach them.
By Javier Alvarez · Updated · 7 min read
19 rows: State insurance law. Public policy, not the member's benefits.
Florida insurance law
Fully insured plans (Fla. Stat. 627.6408) · Florida
| 97802 | Not published |
|---|---|
| 97803 | Not published |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Health insurance policies and group health insurance policies sold in Florida. Covers equipment, supplies, and diabetes outpatient self-management training and educational services used to treat diabetes. [1] |
| Diagnoses | Diabetes (the statute does not list types). [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Not published: call the payer. |
| Referral and prior auth | The patient's treating physician, or a physician who specializes in the treatment of diabetes, must certify that the services are necessary. [1] |
| Who can bill | The policy may require training to be under the direct supervision of a certified diabetes educator or a board-certified endocrinologist, and may require that nutrition counseling be provided by a licensed dietitian. [1] |
| Also | The Agency for Health Care Administration adopts standards for the training, taking into account American Diabetes Association standards. [1] |
- Florida Statutes 2025: s. 627.6408 Diabetes treatment services (Florida Senate), checked October 30, 2026
Vermont insurance law
Fully insured plans (8 V.S.A. 4073) · Vermont
| 97802 | Not published |
|---|---|
| 97803 | Not published |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | A health insurance plan in Vermont. Covers equipment, supplies, and outpatient self-management training and education, including medical nutrition therapy. Recodified and amended effective September 1, 2025. [1] |
| Diagnoses | Insulin-dependent, insulin-using, gestational, and noninsulin-using diabetes. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Not published: call the payer. |
| Referral and prior auth | Must be prescribed by a health care professional. [1] |
| Who can bill | A certified, registered, or licensed health care professional with specialized training in the education and management of diabetes. Dietitians are not named. [1] |
- Vermont Statutes: 8 V.S.A. s. 4073 Diabetes treatment (2025 session text), checked October 30, 2026
Connecticut insurance law
Fully insured plans (Conn. Gen. Stat. 38a-492e and 38a-518e) · Connecticut
| 97802 | Not published |
|---|---|
| 97803 | Not published |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Individual health insurance policies (38a-492e) and group health insurance policies (38a-518e) of the types in subdivisions (1), (2), (4), (11) and (12) of section 38a-469. Benefits carry the same terms and conditions as other benefits under the policy. [1] |
| Diagnoses | Insulin-dependent, insulin-using, gestational, and non-insulin-using diabetes. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Initial training after diagnosis: a maximum of 10 hours. Training after a significant change in symptoms or condition: a maximum of 4 hours. Training because of new techniques and treatment: a maximum of 4 hours. [1] |
| Referral and prior auth | The training must be prescribed by a licensed health care professional who has state authority to prescribe it. [1] |
| Who can bill | A certified, registered or licensed health care professional trained in the care and management of diabetes, within the scope of practice. Dietitians are not named in these two sections. [1] |
- Connecticut General Statutes: Chapter 700c, ss. 38a-492e and 38a-518e (current), checked October 30, 2026
Illinois insurance law
Fully insured plans (215 ILCS 5/356w) · Illinois
| 97802 | Not published |
|---|---|
| 97803 | Not published |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Group policies of accident and health insurance amended, delivered, issued, or renewed after the 1998 amendatory Act. Covers type 1, type 2, and gestational diabetes mellitus. [1] |
| Diagnoses | Type 1 diabetes, type 2 diabetes, and gestational diabetes mellitus. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Up to 3 medically necessary visits to a qualified provider upon initial diagnosis, and up to 2 medically necessary visits after a physician determines a significant change in symptoms or condition. No coverage is required for additional visits. [1] |
| Referral and prior auth | A physician's diagnosis or determination of significant change triggers each visit allowance, and some plans require a referral to the qualified provider. [1] |
| Who can bill | A qualified provider: in an HMO with a primary care physician, the PCP, a referred physician, or a referred certified, registered, or licensed network professional with diabetes expertise. In other plans, a physician or a referred certified, registered, or licensed professional with diabetes expertise. Dietitians are not named. [1] |
| Also | Medical nutrition therapy has the meaning in the Dietitian Nutritionist Practice Act. Cost sharing is the same as for other services by the same type of provider. [1] |
- Illinois Compiled Statutes: 215 ILCS 5/356w Diabetes self-management training and education, checked October 30, 2026
Washington insurance law
Fully insured plans (RCW 48.21.143, 48.44.315 and 48.46.272) · Washington
| 97802 | Not published |
|---|---|
| 97803 | Not published |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Group and blanket disability contracts (RCW 48.21.143), health benefit plans of health care service contractors (RCW 48.44.315), and HMO health benefit plans (RCW 48.46.272), issued or renewed after January 1, 1998. The insurer need not include the coverage in a group contract offered to an employer with a self-insured plan not subject to mandated benefits status under Title 48 that does not offer similar coverage. [1][2][3] |
| Diagnoses | A person with insulin-using diabetes, noninsulin-using diabetes, or elevated blood glucose levels induced by pregnancy, diagnosed by a health care provider. [2] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Coverage may be subject to customary cost-sharing provisions established for other similar services, and may not be reduced or eliminated due to the section. [2] |
| Referral and prior auth | The training and education is covered as ordered by the health care provider. Services are covered when deemed medically necessary by the medical director or designee, subject to any referral and formulary requirements. [2] |
| Who can bill | Only health care providers with expertise in diabetes. The insurer may restrict patients to providers who have signed participating provider agreements. Dietitians are not named. [2] |
- Washington RCW 48.21.143 Diabetes coverage (group disability contracts), checked October 30, 2026
- Washington RCW 48.44.315 Diabetes coverage (health care service contractors), checked October 30, 2026
- Washington RCW 48.46.272 Diabetes coverage (health maintenance organizations), checked October 30, 2026
Massachusetts insurance law
Fully insured plans (M.G.L. c. 175, s. 47N) · Massachusetts
| 97802 | Not published |
|---|---|
| 97803 | Not published |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Individual accident and sickness policies and group blanket policies that provide hospital and surgical expense insurance, except policies supplementing Medicare or other governmental programs. Benefits apply to items within a category of benefits the policy otherwise covers. [1] |
| Diagnoses | Insulin-dependent, insulin-using, gestational, and non-insulin-dependent diabetes. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Not published: call the payer. |
| Referral and prior auth | Items must be prescribed by a health care professional legally authorized to prescribe them and be medically necessary. [1] |
| Who can bill | A certified diabetes health care provider participating with the insurance contract or affiliated with a participating provider. The statute defines this as a licensed health care professional with expertise in diabetes, a registered dietician, or a certified diabetes educator. The insurer need not contract with one it does not already contract with. [1] |
- Massachusetts General Laws: Part I, Title XXII, Chapter 175, Section 47N, checked October 30, 2026
Maryland insurance law
Fully insured plans (Md. Code, Insurance 15-822) · Maryland
| 97802 | Not published |
|---|---|
| 97803 | Not published |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Insurers and nonprofit health service plans providing hospital, medical, or surgical benefits on an expense-incurred basis, and HMOs, under policies and contracts issued or delivered in Maryland. [1] |
| Diagnoses | Insulin-using diabetes, noninsulin-using diabetes, elevated or impaired blood glucose levels induced by pregnancy, and, consistent with American Diabetes Association standards, elevated or impaired blood glucose levels induced by prediabetes. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Deductibles and coinsurance may apply but may not be greater than those for similar coverages under the same policy. Coverage may not be reduced or eliminated due to the section. [1] |
| Referral and prior auth | The insured's treating physician or other appropriately licensed provider, or a physician who specializes in diabetes, must certify the services are necessary. [1] |
| Who can bill | Services are provided through a program supervised by an appropriately licensed, registered, or certified health care provider whose scope of practice includes diabetes education or management. Dietitians are not named. [1] |
- Maryland Code, Insurance Article, s. 15-822, checked October 30, 2026
Nebraska insurance law
Fully insured plans (Neb. Rev. Stat. 44-790) · Nebraska
| 97802 | Not published |
|---|---|
| 97803 | Not published |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Individual or group sickness and accident policies and expense-incurred policies delivered, issued or renewed in Nebraska, except specified-disease or limited-benefit coverage, and self-funded employee benefit plans to the extent not preempted by federal law. [1] |
| Diagnoses | Insulin-dependent, insulin-using, gestational, and non-insulin-using diabetes. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Covered at diagnosis, when symptoms or conditions change, and when new medications or treatments are prescribed. Diabetes self-management education must be deemed medically necessary by a physician, and coverage shall not exceed $500 in a two-year period. [1] |
| Referral and prior auth | Must be prescribed by a health care professional legally authorized to prescribe such items. [1] |
| Who can bill | An American Diabetes Association Recognized Diabetes Self-Management Education Program, or a health care professional who is a diabetes educator certified by the National Certification Board for Diabetes Educators. Dietitians are not named. [1] |
- Nebraska Revised Statute 44-790 Coverage for diabetes; requirements, checked October 30, 2026
Virginia insurance law
Fully insured plans (Va. Code 38.2-3418.10) · Virginia
| 97802 | Not published |
|---|---|
| 97803 | Not published |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Individual or group hospital or major medical policies, hospital or medical subscription contracts, and HMO health care plans. Does not apply to short-term travel, accident only, or limited or specified disease policies, or to Medicare and similar government plan coverage. [1] |
| Diagnoses | Insulin-dependent, insulin-using, gestational, and noninsulin-using diabetes. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | No policy-year or calendar-year dollar or durational benefit limitations or maximums for benefits under the section. The statute specifies in-person training and education. [1] |
| Referral and prior auth | Must be prescribed by a health care professional legally authorized to prescribe such items. [1] |
| Who can bill | A certified, registered or licensed health care professional. A managed care plan may require the professional to be in its network if the network has sufficient qualified professionals. Dietitians are not named. [1] |
- Code of Virginia s. 38.2-3418.10 Coverage for diabetes, checked October 30, 2026
Minnesota insurance law
Fully insured plans (Minn. Stat. 62A.3093) · Minnesota
| 97802 | Not published |
|---|---|
| 97803 | Not published |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Health plans, including a plan described in section 62A.011, subdivision 3, clause (10). Coverage must include persons with gestational, type I or type II diabetes. The Medicare Part D exception applies only to equipment and supplies. [1] |
| Diagnoses | Gestational, type I, or type II diabetes. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Subject to the same deductible or coinsurance as the plan's hospital, medical expense, medical equipment, or prescription drug benefits. A carrier may not reduce or eliminate coverage due to the requirement. [1] |
| Referral and prior auth | Not published: call the payer. |
| Who can bill | A certified, registered, or licensed health care professional working in a program consistent with the American Diabetes Association national standards of diabetes self-management education. Dietitians are not named. [1] |
- Minnesota Statutes s. 62A.3093 Coverage for diabetes, checked October 30, 2026
Kansas insurance law
Fully insured plans (K.S.A. 40-2,163) · Kansas
| 97802 | Not published |
|---|---|
| 97803 | Not published |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Individual or group health insurance policies, medical service plans, hospital service corporation contracts, fraternal benefit societies and HMOs providing accident and health coverage, delivered, issued, amended or renewed on or after January 1, 1999. Excludes Medicare supplement, long-term care, specified disease and accident-only coverage. [1] |
| Diagnoses | Insulin dependent, insulin-using, gestational and noninsulin using diabetes. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Subject to the same annual deductible or coinsurance and the same medical necessity requirement as other covered benefits. The commissioner of insurance enforces the act. [1] |
| Referral and prior auth | Training must be ordered by a health care professional legally authorized to prescribe it. Where a policy requires services by or upon referral from a primary care physician, that requirement applies. [1] |
| Who can bill | A certified, registered or licensed health care professional with expertise in diabetes, when the diabetic is treated at an American Diabetes Association approved program, by a person certified by the national certification board for diabetes educators, or, as to nutritional education, by a licensed dietitian under a treatment plan authorized by the prescribing professional. [1] |
- Kansas Statutes 40-2,163 Diabetes coverage act, checked October 30, 2026
South Dakota insurance law
Fully insured plans (S.D. Codified Laws 58-18-83) · South Dakota
| 97802 | Not published |
|---|---|
| 97803 | Not published |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Every group health insurance policy delivered, issued for delivery, or renewed in South Dakota, except special disease or other limited benefit coverage. Medical nutrition therapy does not include any food items or nonprescription drugs. [1] |
| Diagnoses | Persons diagnosed with diabetes. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Limited to people newly diagnosed or with no prior diabetes education, people who need a change in therapy, people with a comorbid condition such as heart disease or renal failure, or people whose diabetes is unstable. No more than two full education programs per lifetime and up to eight follow-up visits per year need be covered. [1] |
| Referral and prior auth | Must be prescribed by a physician or other licensed health care provider legally authorized to prescribe the treatment. [1] |
| Who can bill | A physician, nurse, dietitian, pharmacist, or other licensed provider who meets the academic eligibility requirements of the National Certification Board for Diabetic Educators and has completed a diabetes education course or is a certified diabetes educator. The training must be based on an American Diabetes Association recognized program or one approved by the ADA or the South Dakota Department of Health. [1] |
Louisiana insurance law
Fully insured plans (La. R.S. 22:1059.4 (Act 762 of 2024)) · Louisiana
| 97802 | Not published |
|---|---|
| 97803 | Not published |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Any health coverage plan delivered or issued for delivery in Louisiana that provides benefits for maternity services. The act defines health coverage plan to include group insurance plans, self-insurance plans, and Office of Group Benefits programs, and excludes excepted benefits, limited benefit plans and short-term policies under 12 months. [1] |
| Diagnoses | Pregnancy. Coverage does not require a diagnosis of gestational diabetes or any other chronic health condition. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Counseling is covered in the first trimester of the pregnancy. Annual deductibles, coinsurance, and copayments consistent with the plan may apply. [1] |
| Referral and prior auth | The treating healthcare provider must recommend the counseling. [1] |
| Who can bill | A licensed dietitian or licensed nutritionist licensed under the Louisiana Dietetics/Nutrition Practice Act of 1987, R.S. 37:3081 et seq. [1] |
| Also | Plan terminology that is discriminatory against licensed dietitians or licensed nutritionists or their services is void and unenforceable. [1] |
- Louisiana 2024 Regular Session Enrolled Senate Bill 300 (Act 762), enacting R.S. 22:1059.4, checked October 30, 2026
Texas insurance law
Fully insured plans (Tex. Ins. Code ch. 1358 and s. 1451.302) · Texas
| 97802 | Not published |
|---|---|
| 97803 | Not published |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Applies to individual, group, blanket and franchise policies and HMO evidence of coverage that provide coverage for diabetes treatment. Small employer health benefit plans written under Chapter 1501 are excepted from subchapter B. [1] |
| Diagnoses | A qualified enrollee has insulin dependent or noninsulin dependent diabetes, elevated blood glucose levels induced by pregnancy, or another medical condition associated with elevated blood glucose levels. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Training covers the period after initial diagnosis, additional training after a significant change in symptoms or condition, and periodic or episodic continuing education training. A plan may apply a deductible, copayment or coinsurance no higher than for analogous chronic conditions. [1] |
| Referral and prior auth | When training is provided on the written order of a physician or other health care practitioner, it must include an ADA-recognized program, a multidisciplinary team, a certified diabetes educator, or defined components such as nutrition counseling. [1] |
| Who can bill | Where the training is delivered by components, nutrition counseling is provided by a licensed dietitian, for which the dietitian shall be paid. A nurse or physician assistant may be paid for nutrition counseling only if a licensed dietitian is unavailable. Section 1451.302 also bars a policy from denying payment for dietitian services within the license scope, tied to an illness the policy covers and a physician recommendation. [1][2] |
Nevada insurance law
Fully insured plans (NRS 689A.0427, 689B.0357, 695B.1927, 695C.1727) · Nevada
| 97802 | Not published |
|---|---|
| 97803 | Not published |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Individual health insurance (NRS 689A.0427), group health insurance (689B.0357), hospital or medical service corporation contracts (695B.1927) and HMO evidence of coverage (695C.1727) that cover hospital, medical or surgical expenses. Applies to policies issued or renewed on or after January 1, 1998. [1][2][3][4] |
| Diagnoses | Diabetes includes type I, type II and gestational diabetes. [1][2][3][4] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Training and education must be medically necessary. It covers the period after initial diagnosis, a later significant change in symptoms or condition, and new techniques and treatment for diabetes. Coverage carries the same deductible, copayment and coinsurance as the rest of the policy. [1][2][3][4] |
| Referral and prior auth | Not published: call the payer. |
| Also | The statute does not say who may provide the counseling in nutrition, so a plan's own network and credentialing rules still decide who is paid. [1][2][3][4] |
- Nevada Revised Statutes Chapter 689A, NRS 689A.0427 (Nevada Legislature), checked October 30, 2026
- Nevada Revised Statutes Chapter 689B, NRS 689B.0357 (Nevada Legislature), checked October 30, 2026
- Nevada Revised Statutes Chapter 695B, NRS 695B.1927 (Nevada Legislature), checked October 30, 2026
- Nevada Revised Statutes Chapter 695C, NRS 695C.1727 (Nevada Legislature), checked October 30, 2026
New Hampshire insurance law
Fully insured plans (RSA 415:6-e, 415:18-f, 415:6-o, 415:18-t) · New Hampshire
| 97802 | Not published |
|---|---|
| 97803 | Not published |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Individual policies (RSA 415:6-e, 415:6-o) and group policies (RSA 415:18-f, 415:18-t) of accident or health insurance that provide benefits for medical or hospital expenses, subject to the terms and conditions of the policy. [1] |
| Diagnoses | Diabetes services are covered for the treatment of diabetes. The obesity section covers diseases and ailments caused by obesity and morbid obesity, for insured persons at least 18 years of age. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Not published: call the payer. |
| Referral and prior auth | Diabetes training and education is covered pursuant to a written order of a primary care physician or practitioner. Obesity treatment, including bariatric surgery, requires a written order from the prescribing physician stating the treatment is medically necessary. [1] |
| Who can bill | Diabetes training and education, including medical nutrition therapy, is provided by a certified, registered, or licensed health care professional with expertise in diabetes. [1] |
| Also | The obesity section says treatment standards may include behavior modification, weight loss, exercise regimens, nutritional counseling, and post-operative counseling of dietary, exercise and lifestyle changes. Its standards are those of the American Society for Metabolic and Bariatric Surgery or the American College of Surgeons. [1] |
Wyoming insurance law
Fully insured plans (W.S. 26-20-201 and 26-22-101) · Wyoming
| 97802 | Not published |
|---|---|
| 97803 | Not published |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Individual and group health insurance, service or indemnity contracts and HMO contracts that provide coverage, for private health benefit plans delivered or issued on or after July 1, 2001. [1] |
| Diagnoses | Insulin-dependent, insulin-using, gestational and noninsulin using diabetes. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Covered training and education is limited to a one-time evaluation and training program when medically necessary within one year of diagnosis, plus additional medically necessary training upon a significant change in symptoms, condition or treatment, limited to three hours per year. Standard deductibles or coinsurance apply. [1] |
| Referral and prior auth | Must be prescribed by a health care professional legally authorized to prescribe such items under Wyoming law. [1] |
| Who can bill | Training and education is provided by a certified, registered or licensed health care professional with expertise in diabetes. Separately, for dietary services, a dietitian registered with the Commission on Dietetic Registration is treated as a licensed person for reimbursement, but an insurer need not pay for dietitian services unless the policy lists them as a benefit. [1] |
Rhode Island insurance law
Fully insured plans (R.I. Gen. Laws 27-18-38) · Rhode Island
| 97802 | Not published |
|---|---|
| 97803 | Not published |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Individual or group health insurance contracts, plans or policies that include coverage for physician office services, and major medical policies and the other broad medical policies the law names. Supplemental policies for specified diseases are excepted. [1] |
| Diagnoses | Insulin treated diabetes, non-insulin treated diabetes, and gestational diabetes. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Self-management education and medical nutrition therapy education is limited to medically necessary visits upon diagnosis of diabetes, when a physician diagnoses a significant change in symptoms or conditions, or when reeducation or refresher training is necessary. Home visits are included when medically necessary. Group settings are allowed. [1] |
| Referral and prior auth | The education must be medically necessary and prescribed by a physician. It may be provided only by the physician or, on the physician's referral, by an appropriately licensed and certified healthcare provider. [1] |
| Payment | Copayments or deductibles may not be greater than those for other supplies, equipment or physician office visits. Benefits are reimbursed under each insurer's own reimbursement principles and mechanisms. [1] |
- Rhode Island General Laws s. 27-18-38, Diabetes treatment (Rhode Island General Assembly), checked October 30, 2026
Colorado insurance law
Fully insured plans (C.R.S. 10-16-104(13)) · Colorado
| 97802 | Not published |
|---|---|
| 97803 | Not published |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Any health benefit plan that provides hospital, surgical, or medical expense insurance, except supplemental policies covering a specified disease or other limited benefit. [1] |
| Diagnoses | Not published: call the payer. |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Not published: call the payer. |
| Referral and prior auth | Medical nutrition therapy and training are covered if prescribed by a health-care provider licensed to prescribe such items under Colorado law. [1] |
| Who can bill | Training and education is provided by a certified, registered, or licensed health-care professional with expertise in diabetes. If coverage is through a managed care plan, the qualified provider must be a participating provider in the plan. [1] |
| Payment | Benefits are subject to the same annual deductibles or copayments as other covered benefits in the policy. Private third-party payors may not reduce or eliminate coverage because of this subsection. [1] |
19 state laws side by side
These are state insurance laws that make a fully insured plan cover nutrition services: most of them diabetes self-management education that includes medical nutrition therapy or nutrition counseling. 15 of the 19 name a dietitian among the providers. A state law reaches the plans that state regulates; a self-funded employer plan is regulated federally, so check the member's plan type on the benefits call. Each state's page quotes the statute's own terms and links to it.
| State | Law | Conditions | Who provides it | Limits |
|---|---|---|---|---|
| Colorado | C.R.S. 10-16-104(13) | Not published: call the payer. | Training and education is provided by a certified, registered, or licensed health-care professional with expertise in diabetes. If coverage is through a managed care plan, the qualified provider must be a participating provider in the plan. | Not published: call the payer. |
| Connecticut | Conn. Gen. Stat. 38a-492e and 38a-518e | Insulin-dependent, insulin-using, gestational, and non-insulin-using diabetes. | A certified, registered or licensed health care professional trained in the care and management of diabetes, within the scope of practice. Dietitians are not named in these two sections. | Initial training after diagnosis: a maximum of 10 hours. Training after a significant change in symptoms or condition: a maximum of 4 hours. Training because of new techniques and treatment: a maximum of 4 hours. |
| Florida | Fla. Stat. 627.6408 | Diabetes (the statute does not list types). | The policy may require training to be under the direct supervision of a certified diabetes educator or a board-certified endocrinologist, and may require that nutrition counseling be provided by a licensed dietitian. | Not published: call the payer. |
| Illinois | 215 ILCS 5/356w | Type 1 diabetes, type 2 diabetes, and gestational diabetes mellitus. | A qualified provider: in an HMO with a primary care physician, the PCP, a referred physician, or a referred certified, registered, or licensed network professional with diabetes expertise. In other plans, a physician or a referred certified, registered, or licensed professional with diabetes expertise. Dietitians are not named. | Up to 3 medically necessary visits to a qualified provider upon initial diagnosis, and up to 2 medically necessary visits after a physician determines a significant change in symptoms or condition. No coverage is required for additional visits. |
| Kansas | K.S.A. 40-2,163 | Insulin dependent, insulin-using, gestational and noninsulin using diabetes. | A certified, registered or licensed health care professional with expertise in diabetes, when the diabetic is treated at an American Diabetes Association approved program, by a person certified by the national certification board for diabetes educators, or, as to nutritional education, by a licensed dietitian under a treatment plan authorized by the prescribing professional. | Subject to the same annual deductible or coinsurance and the same medical necessity requirement as other covered benefits. The commissioner of insurance enforces the act. |
| Louisiana | La. R.S. 22:1059.4 (Act 762 of 2024) | Pregnancy. Coverage does not require a diagnosis of gestational diabetes or any other chronic health condition. | A licensed dietitian or licensed nutritionist licensed under the Louisiana Dietetics/Nutrition Practice Act of 1987, R.S. 37:3081 et seq. | Counseling is covered in the first trimester of the pregnancy. Annual deductibles, coinsurance, and copayments consistent with the plan may apply. |
| Maryland | Md. Code, Insurance 15-822 | Insulin-using diabetes, noninsulin-using diabetes, elevated or impaired blood glucose levels induced by pregnancy, and, consistent with American Diabetes Association standards, elevated or impaired blood glucose levels induced by prediabetes. | Services are provided through a program supervised by an appropriately licensed, registered, or certified health care provider whose scope of practice includes diabetes education or management. Dietitians are not named. | Deductibles and coinsurance may apply but may not be greater than those for similar coverages under the same policy. Coverage may not be reduced or eliminated due to the section. |
| Massachusetts | M.G.L. c. 175, s. 47N | Insulin-dependent, insulin-using, gestational, and non-insulin-dependent diabetes. | A certified diabetes health care provider participating with the insurance contract or affiliated with a participating provider. The statute defines this as a licensed health care professional with expertise in diabetes, a registered dietician, or a certified diabetes educator. The insurer need not contract with one it does not already contract with. | Not published: call the payer. |
| Minnesota | Minn. Stat. 62A.3093 | Gestational, type I, or type II diabetes. | A certified, registered, or licensed health care professional working in a program consistent with the American Diabetes Association national standards of diabetes self-management education. Dietitians are not named. | Subject to the same deductible or coinsurance as the plan's hospital, medical expense, medical equipment, or prescription drug benefits. A carrier may not reduce or eliminate coverage due to the requirement. |
| Nebraska | Neb. Rev. Stat. 44-790 | Insulin-dependent, insulin-using, gestational, and non-insulin-using diabetes. | An American Diabetes Association Recognized Diabetes Self-Management Education Program, or a health care professional who is a diabetes educator certified by the National Certification Board for Diabetes Educators. Dietitians are not named. | Covered at diagnosis, when symptoms or conditions change, and when new medications or treatments are prescribed. Diabetes self-management education must be deemed medically necessary by a physician, and coverage shall not exceed $500 in a two-year period. |
| Nevada | NRS 689A.0427, 689B.0357, 695B.1927, 695C.1727 | Diabetes includes type I, type II and gestational diabetes. | Not published: call the payer. | Training and education must be medically necessary. It covers the period after initial diagnosis, a later significant change in symptoms or condition, and new techniques and treatment for diabetes. Coverage carries the same deductible, copayment and coinsurance as the rest of the policy. |
| New Hampshire | RSA 415:6-e, 415:18-f, 415:6-o, 415:18-t | Diabetes services are covered for the treatment of diabetes. The obesity section covers diseases and ailments caused by obesity and morbid obesity, for insured persons at least 18 years of age. | Diabetes training and education, including medical nutrition therapy, is provided by a certified, registered, or licensed health care professional with expertise in diabetes. | Not published: call the payer. |
| Rhode Island | R.I. Gen. Laws 27-18-38 | Insulin treated diabetes, non-insulin treated diabetes, and gestational diabetes. | Not published: call the payer. | Self-management education and medical nutrition therapy education is limited to medically necessary visits upon diagnosis of diabetes, when a physician diagnoses a significant change in symptoms or conditions, or when reeducation or refresher training is necessary. Home visits are included when medically necessary. Group settings are allowed. |
| South Dakota | S.D. Codified Laws 58-18-83 | Persons diagnosed with diabetes. | A physician, nurse, dietitian, pharmacist, or other licensed provider who meets the academic eligibility requirements of the National Certification Board for Diabetic Educators and has completed a diabetes education course or is a certified diabetes educator. The training must be based on an American Diabetes Association recognized program or one approved by the ADA or the South Dakota Department of Health. | Limited to people newly diagnosed or with no prior diabetes education, people who need a change in therapy, people with a comorbid condition such as heart disease or renal failure, or people whose diabetes is unstable. No more than two full education programs per lifetime and up to eight follow-up visits per year need be covered. |
| Texas | Tex. Ins. Code ch. 1358 and s. 1451.302 | A qualified enrollee has insulin dependent or noninsulin dependent diabetes, elevated blood glucose levels induced by pregnancy, or another medical condition associated with elevated blood glucose levels. | Where the training is delivered by components, nutrition counseling is provided by a licensed dietitian, for which the dietitian shall be paid. A nurse or physician assistant may be paid for nutrition counseling only if a licensed dietitian is unavailable. Section 1451.302 also bars a policy from denying payment for dietitian services within the license scope, tied to an illness the policy covers and a physician recommendation. | Training covers the period after initial diagnosis, additional training after a significant change in symptoms or condition, and periodic or episodic continuing education training. A plan may apply a deductible, copayment or coinsurance no higher than for analogous chronic conditions. |
| Vermont | 8 V.S.A. 4073 | Insulin-dependent, insulin-using, gestational, and noninsulin-using diabetes. | A certified, registered, or licensed health care professional with specialized training in the education and management of diabetes. Dietitians are not named. | Not published: call the payer. |
| Virginia | Va. Code 38.2-3418.10 | Insulin-dependent, insulin-using, gestational, and noninsulin-using diabetes. | A certified, registered or licensed health care professional. A managed care plan may require the professional to be in its network if the network has sufficient qualified professionals. Dietitians are not named. | No policy-year or calendar-year dollar or durational benefit limitations or maximums for benefits under the section. The statute specifies in-person training and education. |
| Washington | RCW 48.21.143, 48.44.315 and 48.46.272 | A person with insulin-using diabetes, noninsulin-using diabetes, or elevated blood glucose levels induced by pregnancy, diagnosed by a health care provider. | Only health care providers with expertise in diabetes. The insurer may restrict patients to providers who have signed participating provider agreements. Dietitians are not named. | Coverage may be subject to customary cost-sharing provisions established for other similar services, and may not be reduced or eliminated due to the section. |
| Wyoming | W.S. 26-20-201 and 26-22-101 | Insulin-dependent, insulin-using, gestational and noninsulin using diabetes. | Training and education is provided by a certified, registered or licensed health care professional with expertise in diabetes. Separately, for dietary services, a dietitian registered with the Commission on Dietetic Registration is treated as a licensed person for reimbursement, but an insurer need not pay for dietitian services unless the policy lists them as a benefit. | Covered training and education is limited to a one-time evaluation and training program when medically necessary within one year of diagnosis, plus additional medically necessary training upon a significant change in symptoms, condition or treatment, limited to three hours per year. Standard deductibles or coinsurance apply. |
Your state isn't here?
We only add a state when we have read the statute itself on the state's own site. No law on this page doesn't mean no coverage: the plan's own policy still decides, so look the payer up in the coverage table.