We are writing on behalf of Registered Dietitian Nutritionists (RDs/RDNs)  to advocate for increased Anthem reimbursement for RDs/RDNs providing Medical Nutrition Therapy (MNT) to Anthem members.

This effort reflects a shared commitment to improve the nation’s health and advance the profession of nutrition and dietetics through research, education, and advocacy.

To restore stability, preserve access, and improve health outcomes for Anthem members, we respectfully and firmly submit the following two requests:

Our Requests
1. A meeting with Anthem/Elevance Provider Relations within 30 days: To discuss Medical Nutrition Therapy (MNT) access and reimbursement, with the goal of ensuring fair and reasonable payment that allows Anthem members to retain timely, effective, and sustainable access to outpatient nutrition services.

2. Ongoing, transparent collaboration with the RD's/RDN's
To support long-term sustainability, network adequacy, and integrity for outpatient MNT services, including hospital-based, health system–affiliated, and community-based settings.

This request is grounded in a shared commitment to protecting preventive care, optimizing outcomes-based practice, and ensuring fiscal responsibility—values we believe Anthem shares.

Current Reimbursement Concerns
Anthem’s current reimbursement for CPT codes 97802 and 97803 is significantly lower than established public benchmarks, including Medicare and, in some states, Medicaid. 

Medicare Rates – Connecticut (For reference) - (CMS Physician Fee Schedule)- https://www.cms.gov/medicare/payment/fee-schedules/physician. Rate is per 15 minute unit. 

Connecticut Medicaid Rates- (Effective July 1, 2025)

How Anthem Compares

While Medicare and Medicaid have adjusted rates over time, Anthem reimbursement for outpatient MNT services has not increased since 2015 (Over a decade!). When adjusted for inflation and the rising cost of living, this represents an approximately 25–30% erosion in real-dollar value.

As a result:

• Anthem reimbursement for outpatient MNT is substantially below Medicare, and lower than Medicaid, despite serving a commercially insured population. This creates a growing misalignment between reimbursement and the true cost of delivering outpatient nutrition care.

Why This Matters for Access and Sustainability
Over the past decade, the cost of operating outpatient healthcare services in the US has increased significantly, including:

• Wages and benefits for licensed clinicians
• Rent, utilities, and facility costs
• Technology, electronic health records, and compliance requirements
• Administrative, billing, and insurance-related overhead

When reimbursement fails to keep pace with inflation and cost of living, healthcare organizations are forced to:

• Limit or discontinue acceptance of Anthem-insured patients
• Reduce appointment availability or shorten visit lengths
• Delay hiring or eliminate nutrition positions and departments
• Scale back outpatient nutrition services entirely

Patients—Anthem members—are directly impacted through longer wait times, reduced access, or full out-of-pocket costs for essential, evidence-based nutrition care.

 The Value of MNT: High-Impact, Cost-Saving Care
Medical Nutrition Therapy is a well-established, evidence-based intervention with strong clinical outcomes and return on investment:

• Diabetes: MNT can reduce HbA1c by up to 2%, delaying insulin initiation and reducing complications, yielding average annual cost savings of $3,000–$6,000 per patient (Academy of Nutrition and Dietetics, 2020; American Diabetes Association, 2018).
• Cardiovascular Disease: MNT leads to significant reductions in LDL cholesterol, blood pressure, and triglycerides, reducing reliance on medications and procedures (Journal of the Academy of Nutrition and Dietetics, 2009).
• GI and Liver Disorders: RDN involvement reduces emergency department visits, unnecessary imaging, and medication overuse for patients with IBS, IBD, and NAFLD (ASPEN, 2022).
• Obesity & Bariatric Prevention: MNT reduces the need for bariatric surgery, which typically costs $15,000–$25,000 per case, excluding long-term complication management (NIH, 2016).

A CMS cost-effectiveness review further found that every $1 spent on MNT yields up to $4 in medical savings (CMS, 2016).

Real-World Impact on Anthem Members
A Connecticut patient, a 57-year-old man with pre-diabetes and NAFLD, was referred for nutrition counseling while preparing to initiate GLP-1 therapy. After four months of MNT—without medication—his A1c decreased from 6.9% to 5.7%, liver enzymes normalized, and pharmacologic therapy was no longer required.

This is one of hundreds of similar outcomes across the state and highlights the clinical and financial value of accessible outpatient MNT services.

However, practices and healthcare organizations across Connecticut are now scaling back or terminating Anthem participation because current reimbursement structures do not support sustainable care delivery.

What We Are Requesting

• A meeting with Anthem / Elevance Provider Relations within 30 days to discuss MNT access and reimbursement. 
• Ongoing, transparent collaboration with the Academy of Nutrition and Dietetics to ensure long-term sustainability and network adequacy for outpatient MNT services.

Our Commitment
We are committed to helping Anthem members live longer, healthier lives through evidence-based nutrition therapy. We are eager to collaborate, share data, and work with Anthem and healthcare systems across the country to develop sustainable solutions that improve outcomes and control long-term healthcare costs.

Thank you for your time and attention. We look forward to your response.

Sincerely,

The Undersigned Registered Dietitian Nutritionists and Other Healthcare Professionals