Washington insurance law on MNT and nutrition counseling
The short answerWashington requires group disability insurers, health care service contractors and HMOs to cover diabetes outpatient self-management training and education, including medical nutrition therapy, as ordered by the health care provider. Only providers with expertise in diabetes may deliver it.
By Javier Alvarez · Updated · 2 min read
1 row: State insurance law · Washington. Public policy, not the member's benefits.
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
What the Washington law says
- 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.
- Diagnoses. A person with insulin-using diabetes, noninsulin-using diabetes, or elevated blood glucose levels induced by pregnancy, diagnosed by a health care provider.
- 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.
- 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.
- 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.
What it means for a claim in Washington
The law sets a floor for the plans it reaches; the plan's own policy and the member's contract still decide the codes, units and referral. On the benefits call, ask whether the plan is fully insured in Washington, and if a covered service is denied, name the statute by section in the appeal. The sources below link to the statute itself.
Payers with their own row for Washington: Kaiser Permanente, Washington Apple Health (Medicaid), Premera Blue Cross, Regence BlueShield and PacificSource. The state laws side by side compare Washington with other states.