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Reimbursement depends on: Medical necessity Specific ICD-10 code selection Accompanying clinical data (e.g., BMI, comorbidities) Medicare Coverage Notes: Medicare reimburses for Intensive Behavioral Therapy (IBT) for obesity under certain conditions: BMI must be 30 Services must be delivered in primary care settings Use of specific CPT/HCPCS codes like G0447 Private Payer Policies: Vary by state and insurer May require prior authorization for obesity medications or surgery Often look for ICD-10 E66.2 , BMI Z-codes, and documented comorbidities Pro Tip: Review the payers coverage determination policy before submitting claims for obesity-related treatments

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I was like, This is not my body. I wanted to feel good in my own body, said Sifuentes

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