Back in 2017, I wrote a blog called “Tips for Setting Fees in Private Practice.” Today’s blog post is an updated version of what to consider when setting your rates in private practice as a Dietitian. I added in some more resources and identified some of the basics with insurance billing (if you decide to become a provider).
**As a reminder, all information provided in this post is for educational purposes only. This information is not a substitute for medical or legal advice.**
Setting Your Hourly Rate
When thinking about your hourly rate, there are three key things you want to consider: what other RDs in the area are charging, your demographic area, and your experience and education. When I first set my rates, I started much lower than where I am today. Over the years with gaining experience, getting my masters, and obtaining specialty certifications, I slowly increased my rates to match the value I bring as a Dietitian.
When considering your rates, you also want to think about your desired yearly income. While this won’t be what you make right away, this could allow you to set monthly goal targets. Check out the blog for more information on setting income goals.
Consider Offering Packages
Offering packages can be a great way to offer services at a discounted price OR lump together two types of services (like personal training and nutrition counseling or nutrition counseling and coaching). When designing your packages, make sure you are clear about what is included (think “package perks”). I would also suggest having a breakdown of the services and related cost in the event you are billing a portion to insurance.
I offer a freebie session for all new clients (Dietitians included) and this is an opportunity for me to not only ensure we are a good fit, but also, review the services and package options I offer. Personally, I also post my rates on my website so clients know what to expect ahead of time. **Important to note that while you can post your rates (i.e. what you charge), you cannot share your reimbursement rates from insurance if you are a provider. This may vary by insurance plan so please review your individual provider contract.**
How This Relates to Insurance Billing
Billing insurance (to be covered in a later post) slightly changes the game. When you bill insurance, you will still bill your usual and customary rate (i.e. your set hourly rate); however, you will only be reimbursed your contractual allowance. This is all based on your set fee schedule, which is provided by each insurance company (and typically provided in the contracting phase). Dietitians are considered “fee-for-service” providers, similar to other healthcare professionals, which basically means we render the service and then bill insurance for reimbursement.
Key Terms to Know for Insurance Billing
With insurance, there are a few key things you will need to understand to bill appropriately.
The first are CPT® (Current Procedural Terminology) codes, which describe professional services rendered by healthcare professionals (including Dietitians). Two codes many Dietitians utilize are: 97802 (initial assessment – face to face – individual) and 97803 (reassessment – face to face – individual). CPT® codes are billed in 15-minute increments (1 “unit” being 15-minutes). Billable time for insurance is the real time interaction you have with a client that is synchronous. This can be done face-to-face (like in an office setting), via secure video (HIPAA compliant), or via telephone. This wouldn’t involve the time you spend preparing for a session or emailing clients resources (although email/text coaching could be an add-on). Each insurance company has specific policies regarding telehealth and reimbursement so make to review them.
The second is ICD-10-CM codes which describe an individual’s disease or medical condition. It is important to note that some codes will require referral from a physician (to specify the diagnosis) and some codes are not billable by Dietitians. One example of an ICD-10-CM code would be Z71.3, which is “Dietary counseling and surveillance”.
Billing insurance can be daunting to learn, so drop a comment below with questions you have about the process.
Insurance Billing Resources
- If you are interested in seeing Medicare’s fee schedule, here is a link for the public information
- For information on the CMS’ 8-minute rule.
- Today’s Dietitian has a post on billing and reimbursement with information on CPT and G codes.
- The Reimbursement Dietitian has a short blog explaining CPT codes commonly used by RDs.
- For information on ICD-10-CM from the CMS
- The Academy of Nutrition has resources on payment.
For more information, check out the My RD Journey Podcast “All About Getting Paid”.
Disclaimer: Information provided is not intended to constitute legal or medical advice. All information is for educational purposes only.