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Nutrition
SERVICE FEE MEMORANDUM MS-98-99-30
DATE: September 16, 1999
RE: Nutrition Counseling Services, Bluegrass Nutrition
Effective immediately, the following fees may be allowed to Bluegrass Nutrition Counseling (formerly Nutrition Consultant Services, Inc.) for the purchase of nutritional counseling services provided in conjunction with eating disorders therapy.
GUIDELINES
PHYSICIAN EVALUATION AND MONITORING
Coverage for nutritional counseling services may be provided only when recommended by a physician. Medical monitoring must be continued throughout the nutritional counseling program.
COUNSELING SESSIONS
Thirty (30) one-hour nutritional counseling sessions may be covered as long as the need for services is evident and measurable progress is being shown. Any request for an extension of treatment should be submitted in writing by the vendor to the rehabilitation specialist.
FEE SCHEDULE
RELATIVE VALUE CODE PROCEDURE ALLOWABLE FEE
By Report Initial Nutritional Assessment $75.00 By Report Follow-Up Assessment (One Hour) 50.00 By Report Follow-Up Assessment (Half Hour) 25.00 By Report One Hour Nutritional Counseling Session 50.00 By Report Half-Hour Nutritional Counseling Session 25.00
AUTHORIZATIONS
Issue pay document for the Initial Nutritional Assessment prior to the provision of service and invoice for payment upon receipt of bill and report. Issue pay documents covering treatment services monthly and invoice upon receipt of bill and progress reports.
VENDOR NUMBER: 611251687-00
VENDOR NAME/ADDRESS: BLUEGRASS NUTRITION COUNSELING 535 W SECOND ST STE 207 LEXINGTON KY 40508
CONTACT PERSON: Tina P. Thompson Phone: 606-388-9152
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