W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!Affordable Care Act Mandates Insuran...
W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!What is Covered for Obesity Treatmen...
W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!IBT For Obesity Is A Stand Alone Ben...
W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!What Should The Health Care Provider...
W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!Primary Care Setting Defined For IBT...
W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!Who Are Primary Care Physicians and ...
W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!Frequency Of Visits Covered For Obes...
W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!Intensive Behavioral Therapy for Obe...
W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!Coinsurance or Copayment and Deducti...
W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!Coding and Diagnosis Information Pro...
W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!Diagnosis RequirementsUse one of the...
W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!How can W8MD Medical Weight Loss Cen...
W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!Most Insurances AcceptedAnd the best...
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W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!W8MD Medical Weight Loss Centers Tha...
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W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!W8MD Medical Weight Loss Telemedicin...
W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!Disclaimer:The information on this w...
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Medicare coverage for weight loss physician and healthcare provider visits must know facts for patients and providers

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Did you know Medicare covers Obesity Related Physician and other healthcare provider visits for obese patients or even certain overweight patients for up to 22 visits in the 1st 6 months? Here is more information on this.

Effective for claims with dates of service on or after November 29, 2011, CMS covers intensive behavioral therapy for obesity, defined as a body mass index (BMI) > 30 kg/m2, for the prevention or early detection of illness or disability.
Intensive behavioral therapy for obesity consists of the following:
Screening for obesity in adults using measurement of BMI calculated by dividing weight in kilograms by the square of height in meters (expressed kg/m2);
Dietary (nutritional) assessment; and
Intensive behavioral counseling and behavioral therapy to promote sustained weight loss through high intensity interventions on diet and exercise.
The intensive behavioral intervention for obesity should be consistent with the 5-A framework that has been highlighted by the USPSTF:
Assess: Ask about/assess behavioral health risk(s) and factors affecting choice of behavior change goals/methods.
Advise: Give clear, specific, and personalized behavior change advice, including information about personal health harms and benefits.
Agree: Collaboratively select appropriate treatment goals and methods based on the patient’s interest in and willingness to change the behavior.
Assist: Using behavior change techniques (self-help and/or counseling), aid the patient in achieving agreed-upon goals by acquiring the skills, confidence, and social/environmental supports for behavior change, supplemented with adjunctive medical treatments when appropriate.
Arrange: Schedule follow-up contacts (in person or by telephone) to provide ongoing assistance/support and to adjust the treatment plan as needed, including referral to more intensive or specialized treatment.
For Medicare beneficiaries with obesity, who are competent and alert at the time that counseling is provided and whose counseling is furnished by a qualified primary care physician or other primary care practitioner and in a primary care setting, CMS covers:
One face-to-face visit every week for the first month;
One face-to-face visit every other week for months 2-6;
One face-to-face visit every month for months 7-12, if the beneficiary meets the 3kg weight loss requirement during the first six months as discussed below.
At the six month visit, a reassessment of obesity and a determination of the amount of weight loss must be performed. To be eligible for additional face-to-face visits occurring once a month for an additional six months, beneficiaries must have achieved a reduction in weight of at least 3kg over the course of the first six months of intensive therapy.

W8MD Medical Weight Loss Centers Of America Provides Intensive Behavior Therapy For Obesity and can bill Medicare directly for eligible patients at participating locations. Visit http://www.w8md.com to learn more.

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Medicare coverage for weight loss physician and healthcare provider visits must know facts for patients and providers

  1. 1. W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!Affordable Care Act Mandates Insurance Coverage ForObesityAffordable Care Act of 2010 mandates all insurances,including Medicare, to provide full insurance coverage forobesity!In March, 2011, Medicare announced it will cover for ObesityPrevention for eligible beneficiaries for up to 22 visits to aqualified healthcare provider in the first 6 months. During thisperiod, if the beneficiary is able to lose about 6.6 lbs. Ormore, coverage will be extended to another 6 months.1(800)W8MD-007 NE Philadelphia, And King Of Prussia in PA New York City Stamford, CT
  2. 2. W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!What is Covered for Obesity Treatment And CounselingBy Medicare?Dietary (nutritional) assessment; and Intensive behavioralcounseling and behavioral therapy to promote sustainedweight loss through high intensity interventions on diet andexercise.Intensive Behavioral Therapy for Obesity Medicare providescoverage of IBT for obesity (BMI ≥ 30 kilograms per metersquared) for Medicare beneficiaries:► Who are competent and alert at the time thatcounseling is provided; and► Whose counseling is furnished by aqualified primary care physician or otherprimary care practitioner and in a primarycare setting.1(800)W8MD-007 NE Philadelphia, And King Of Prussia in PA New York City Stamford, CT
  3. 3. W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!IBT For Obesity Is A Stand Alone BenefitThe IBT for obesity benefit covered by Medicareis a stand alone billable service. It is separate fromthe Initial Preventive Physical Examination (IPPE)or the Annual Wellness Visit (AWV). Medicarebeneficiaries may obtain IBT for obesity servicesat any time following Medicare Part B enrollment,including during their IPPE or AWV encounter.1(800)W8MD-007 NE Philadelphia, And King Of Prussia in PA New York City Stamford, CT
  4. 4. W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!What Should The Health Care Provider Do To QualifyFor Intensive Behavior Therapy For Obesity(IBT) ForMedicare?Each IBT for obesity must be consistent with the 5A’sapproach adopted by the USPSTF. This approach includes:1. Assess: Ask about or assess behavioral health risk(s) andfactors affecting choice of behavior change goals or methods;2. Advise: Give clear, specific, and personalized behaviorchange advice, including information about personal healthharms and benefits;3. Agree: Collaboratively select appropriate treatment goalsand methods based on the beneficiary’s interest in andwillingness to change the behavior;4. Assist: Using behavior change techniques (self-help and/orcounseling), aid the beneficiary in achieving agreed-upongoals by acquiring the skills, confidence, and socialor environmental supports for behavior change, supplementedwith adjunctive medical treatments when appropriate; and5. Arrange: Schedule follow-up contacts (in person or bytelephone) to provide ongoing assistance or support and toadjust the treatment plan as needed, including referral tomore intensive or specialized treatment.1(800)W8MD-007 NE Philadelphia, And King Of Prussia in PA New York City Stamford, CT
  5. 5. W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!Primary Care Setting Defined For IBT For ObesityFor the purpose of this benefit, a primary caresetting is defined as one in which there is a provision ofintegrated, accessible health care services by clinicians whoare accountable for addressing a large majority of personalhealth care needs, developing a sustained partnershipwith patients, and practicing in the context of family andcommunity. The following are not considered primary caresettings under this definition:► Ambulatory surgical centers,► Emergency departments,► Hospices,► Independent diagnostic testing facilities,► Inpatient hospital settings,► Inpatient rehabilitation facilities, and► Skilled nursing facilities.Medicare covers IBT for obesity provided in:► An independent clinic,► An outpatient hospital,► A physician’s office, or► A state or local public health clinic.1(800)W8MD-007 NE Philadelphia, And King Of Prussia in PA New York City Stamford, CT
  6. 6. W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!Who Are Primary Care Physicians and Practitioners ForMedicare That Qualify For IBT For Obesity?For the purpose of the IBT for obesity benefit:Primary Care PhysicianA physician who has a primary specialty designation of:Family practice,General practice,Geriatric medicine,Internal medicine,Obstetrics/gynecology, orPediatric medicine.Primary Care PractitionerA qualified non-physician practitioner is a:Certified clinical nurse specialist,Nurse practitioner, orPhysician assistant.Primary care physicians’ and practitioners’corresponding specialty codes apply when billingprofessional claims. When billing institutional claims,follow billing instructions based on your facility type.1(800)W8MD-007 NE Philadelphia, And King Of Prussia in PA New York City Stamford, CT
  7. 7. W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!Frequency Of Visits Covered For Obesity By MedicareMedicare covers a maximum of 22 IBT for obesity sessions ina 12-month period.Medicare beneficiaries who meet the previously mentionedcriteria are eligible for:► One face-to-face visit every week for the first month;► One face-to-face visit every other week for months 2 – 6;and► One face-to-face visit every month for months 7 – 12, ifthe beneficiary meets the 3 kg (6.6 pounds) weight lossrequirement during the first 6 months.1(800)W8MD-007 NE Philadelphia, And King Of Prussia in PA New York City Stamford, CT
  8. 8. W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!Intensive Behavioral Therapy for ObesityAt the 6-month visit, a reassessment of obesity and adetermination of the amount of weight loss must beperformed. To be eligible for additional face-to-face visitsoccurring once a month for an additional 6 months,beneficiaries must have achieved a reduction in weight of atleast 3 kg (6.6 pounds) over the course of the first 6 monthsof intensive therapy. This determination mustbe documented in the physician office records for applicablebeneficiaries consistent with usual practice. For beneficiarieswho do not achieve a weight loss of at least 3 kg (6.6 pounds)during the first 6 months of intensive therapy, a reassessmentof their readiness to change and BMI is appropriate after anadditional 6-month period.1(800)W8MD-007 NE Philadelphia, And King Of Prussia in PA New York City Stamford, CT
  9. 9. W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!Coinsurance or Copayment and DeductibleThe beneficiary pays nothing (no coinsurance or copaymentand no Medicare Part B deductible) for IBT for obesity.Financial responsibilities may apply for the beneficiary if theprovider does not accept assignment.DocumentationMedical records must document all coverage requirements,including the determination of weight loss at the 6-monthvisit.1(800)W8MD-007 NE Philadelphia, And King Of Prussia in PA New York City Stamford, CT
  10. 10. W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!Coding and Diagnosis Information Procedure Codes andDescriptors Use the following Healthcare CommonProcedure Coding System (HCPCS) codeHCPCS Code for IBT for ObesityG0447 Face-to-face behavioral counseling for obesity, 15minutes1(800)W8MD-007 NE Philadelphia, And King Of Prussia in PA New York City Stamford, CT
  11. 11. W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!Diagnosis RequirementsUse one of the following International Classification ofDiseases, 9th Revision, Clinical Modification (ICD-9-CM)screening (“V”) diagnosis code(s).Diagnosis Codes for IBT for ObesityICD-9-CM Diagnosis Code Code DescriptorV85.30 Body Mass Index 30.0 – 30.9, adultV85.31 Body Mass Index 31.0 – 31.9, adultV85.32 Body Mass Index 32.0 – 32.9, adultV85.33 Body Mass Index 33.0 – 33.9, adultV85.34 Body Mass Index 34.0 – 34.9, adultV85.35 Body Mass Index 35.0 – 35.9, adultV85.36 Body Mass Index 36.0 – 36.9, adultV85.37 Body Mass Index 37.0 – 37.9, adultV85.38 Body Mass Index 38.0 – 38.9, adultV85.39 Body Mass Index 39.0 – 39.9, adultV85.41 Body Mass Index 40.0 – 44.9, adultV85.42 Body Mass Index 45.0 – 49.9, adultV85.43 Body Mass Index 50.0 – 59.9, adultV85.44 Body Mass Index 60.0 – 69.9, adultV85.45 Body Mass Index 70 and over, adultLearn more1(800)W8MD-007 NE Philadelphia, And King Of Prussia in PA New York City Stamford, CT
  12. 12. W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!How can W8MD Medical Weight Loss Centers InsurancePhysician Weight Loss Program Help Me Lose Weight?Our physicians and staff are committed to offering a comprehensiveand individualized approach. W8MD physicians partner with eachpatient to develop a custom weight management program to bestmeet their individual needs.If you are a bit overweight or obese, take long term medications forcholesterol, blood pressure or diabetes but your doctor has nothing tooffer for weight loss other than simply say "lose weight", you maywant to consider W8MD!Under the direction of a trained obesity medicine/weight lossphysician, W8MD Weight Loss Centers can help you overcomeobesity and to make a difference. The doctor’s of W8MD partnerwith each patient to develop a custom weight management programto best meet their individual needs taking into account their medicalhistory, lifestyle and goals.Since weight and sleep go together, most of the W8MD centers areable to address sleep issues such as snoring, obstructive sleep apnea,narcolepsy, insomnia and restless leg syndrome to name a few.1(800)W8MD-007 NE Philadelphia, And King Of Prussia in PA New York City Stamford, CT
  13. 13. W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!Most Insurances AcceptedAnd the best part of the program is that most insurance’s cover thedoctor visits.Check out our website at www.w8md.com to learn more about us. Ifyou have a little or a lot of weight to lose and want to do it withoutsurgery, set up fees and mandatory meal replacements or appetitesuppressants, think W8MD for weight loss.1(800)W8MD-007 NE Philadelphia, And King Of Prussia in PA New York City Stamford, CT
  14. 14. W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!Physician Weight Loss Franchise OpportunitiesAnd, if you are a physician, with an interest in helpingyour obese or overweight patients, and would like to add aW8MD program at your office, please feel free to contactus.Most physicians have nothing tooffer their overweight patients otherthan simply say"Lose Weight!" orhand out a diet sheet. This is notuseful for most patients as obesityneeds a more thorough and structured approach!Physicians Be A W8MD!If you are a physician interested in helping your obese oroverweight patients lose weight safely and effectively usingevidence based non-surgical weight loss methods and workwith their insurance for the visits, W8MDs physician licensing program canhelp.As a Limited Time Offer, we are waiving all signup fees forthe first 50 physicians that Join W8MD Network of Weight LossPhysicians. What are you waiting for? Call 1-800-W8MD-007.1(800)W8MD-007 NE Philadelphia, And King Of Prussia in PA New York City Stamford, CT
  15. 15. W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!W8MD Medical Weight Loss Centers That AcceptInsurances Including Medicare For Obesity• NYC Insurance Weight Loss Center: 2003, BathAvenue, Brooklyn, NY, 11214 Ph: 1-718-946-5500• Philadelphia Insurance Weight Loss Center: 1718,Welsh Rd, Philadelphia, PA, 19115 Ph: 1-215-676-2334• King Of Prussia Weight Loss Center: 987 Old EagleSchool Rd, Wayne, PA, 19087 Ph: 1-800-986-3007• Specialties: Weight Loss Service, Sleep Clinic, SleepStudy Clinics, Sleep Apnea Clinic, Medical Weight Loss,Weight Loss Pills, Weight Loss Supplements, FastWeight Loss Options, weight loss diet, weight lossprogram, Lose Weight Philadelphia, Weight Loss NYC,New York Weight Loss Clinic, Adipex, Phentermine,Generic Combination of Phetermine and Topiramate (likein Qsymia), Weight Loss Diet Pills, NYC Weight LossService• Cities Served: Philadelphia, King Of Prussia, Wayne,Brooklyn, Staten Island, Manhattan, New York, NewYork City, Queens, Long Island, Bronx, Bensonhurst.• Counties Served: Chester, Philadelphia, Bucks,Montgomery, Burlington, Kings, Richmond, Queens,Manhattan, Bronx1(800)W8MD-007 NE Philadelphia, And King Of Prussia in PA New York City Stamford, CT
  16. 16. W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!W8MD Medical Weight Loss Centers That AreFee For Service• W8MD at Optimal Health, 111 High Ridge Rd, Stamford,CT 06905. Ph: 203-348-8805 Fax: 203-348-6398.This email address is being protected fromspambots. You need JavaScript enabled to view it.This Center is Fee For Service.Call 1(800)W8MD-007 to learn more! You have nothing tolose but your unwanted pounds.1(800)W8MD-007 NE Philadelphia, And King Of Prussia in PA New York City Stamford, CT
  17. 17. W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!W8MD Medical Weight Loss Telemedicine ProgramIf you do not have a W8MD location near you, you canstill consult with one of our weight loss physicians usingtelemedicine. We offer a comprehensive telemedicinenutrition, behavior and weight loss consultation with aweight loss doctor for a low price of $150.00 USD for a 30minute telemedicine consultation with certain limitations.Call 1(800)W8MD-007 to learn more.If you have insulin resistance, belly weight, elevatedtriglycerides, history of high blood pressure etc. you mightbe at risk for metabolic syndrome. An obesity medicinephysician can not only help you lose weight, but alsoreduce the risk of diabetes, prediabetes and close to 50different other obesity related problems by helping youlose weight.THINK W8MD (Weight MD) for Weight Loss!http://www.w8md.com/1(800)W8MD-007 NE Philadelphia, And King Of Prussia in PA New York City Stamford, CT
  18. 18. W8MD Medical Weight Loss Centers Of America - Lose Weight, Sleep Better & Live Longer!Disclaimer:The information on this website is not intended todiagnose, treat, cure, or prevent any disease. Alwaysconsult with a licensed and trained physician beforeattempting any weight loss!1(800)W8MD-007 NE Philadelphia, And King Of Prussia in PA New York City Stamford, CT

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