Insurance, Fees, and Frequently Asked Questions

Deidra Sisk MS RD, dietitian at Ruby Oak Nutrition in Raleigh NC. Deidra is sitting in a grey room on an office chair at a desk, smiling at the camera

We're in-network with:

Is Ruby Oak Nutrition in-network with my insurance plan?

Ruby Oak Nutrition is an in-network provider with Blue Cross and Blue Shield, Cigna, Meritain Health, Aetna, Medcost and the North Carolina State Employee Health Plan. You should always verify that we’re in your specific network, since we’re not in-network with all HMO or other limited network plans.

We’re not in-network with United, Medicare (including Advantage Plans), Medicaid, Tri-Care, or any other health insurance plan.

 

How much does nutrition counseling cost?

If we’re out of network with your insurance plan, if sessions aren’t covered by your insurance company, or if you’re paying out-of-pocket for any other reason, our session rates are as follows:

For appointments with Christine Byrne, Deidra Sisk, Serena Hutchinson, or Sarah Booth:

  • $255 for an 85-minute initial appointment
  • $215 for a 55-minute initial appointment
  • $235 for an 85-minute follow-up appointment
  • $180 for a 55-minute follow-up appointment
  • $100 for a 25-minute follow-up appointment (established clients only)

For appointments with all Ruby Oak Nutrition dietitians not named in the section above:

  • $235 for an 85-minute initial appointment
  • $195 for a 55-minute initial appointment
  • $215 for an 85-minute follow-up appointment
  • $160 for a 55-minute follow-up appointment
  • $90 for a 25-minute follow-up appointment (established clients only)

What states are you licensed to see clients in?

We see clients in person at our Downtown Raleigh office.

Virtual nutrition counseling is available across several states in the US, via a HIPAA-compliant video platform.

  • North Carolina
  • Arizona
  • Colorado
  • Connecticut
  • Florida*
  • Indiana
  • Michigan
  • New Jersey
  • New York
  • Pennsylvania
  • Texas
  • Virginia
  • Vermont

*Select dietitians are licensed in this state. We’ll let you know which dietitians you’re able to work with.

 

How nutrition counseling works

Step 1:

Request an appointment with one of our dietitians

Fill out our appointment request form with some information about yourself and what you need help with. We’ll send an email with more information and a booking link within 48 hours. We’ll also give you a call, since we know some people prefer scheduling over the phone.

Request an appointment

Step 2:

Confirm your appointment, fill out the required paperwork, and verify your insurance benefits

Once you’ve booked an appointment, we’ll send you forms to fill out prior to your session. 

Before your first session, you’ll reach out to your insurance company to confirm your in-network benefits (if you have Aetna, Blue Cross Blue Shield, Cigna, or Meritain health insurance) or out-of-network benefits (if you have any other insurer). If you have the NC State Employee Health Plan, there’s no need to verify your benefits — you have unlimited visits with a dietitian at no out-of-pocket cost.

Step 3:

Have your initial nutrition counseling session

The nutrition counseling process looks pretty much the same whether you meet with your dietitian virtually or in person. During the initial session, your dietitian will introduce themselves, share more about our practice and office policies, and make sure to answer any questions you have.

Then, they’ll ask you lots of questions to get a sense of who you are, what you’re struggling with, and what your goals are for nutrition counseling. By the end of your initial appointment, you and your dietitian will agree on some long-term goals and a plan for reaching them. (Of course, all of this is subject to change — and often does! — as you continue to work together.)

Step 4:

Continue meeting regularly with your dietitian

Depending on your situation and your goals, your dietitian might suggest meeting weekly, bi-weekly, or at another regular frequency. You’ll have a standing appointment time (for example, 4 PM on Thursdays), and each session you’ll take small steps towards your long-term goals. 

Nutrition counseling is a process, not a quick fix, and you probably won’t get much out of just a couple sessions.

Frequently Asked Questions

Does my Aetna or Meritain plan cover nutrition counseling with a dietitian?

If you have an Aetna or Meritain Health plan (or another plan that uses the Aetna provider network):

Aetna plans typically cover 10-26 nutrition counseling visits per 12-month period for patients that have a BMI of 30+, or who have high blood pressure, high cholesterol, diabetes, or a high-risk pregnancy. Aetna may cover visits for other patients, but it depends on the plan and may be subject to a deductible.  Aetna typically covers unlimited visits if you have an eating disorder or another qualifying medical diagnosis. Some plans may require that you pay a small co-pay or co-insurance.

Meritain Health plans typically cover 10-26 nutrition counseling visits per 12-month period for all patients, and unlimited visits if you have an eating disorder or another qualifying medical diagnosis.

The only way to know your coverage for certain is to call your insurance company and verify your benefits

Does my BCBS plan cover nutrition counseling with a dietitian?

BCBS NC plans typically cover 30 nutrition counseling visits per year at no out-of-pocket cost. BCBS plans from other states may cover unlimited visits. Some plans cover fewer visits, and some require certain diagnoses for coverage.

The only way to know your coverage for certain is to call your insurance company and verify your benefits.

Does my Cigna plan cover nutrition counseling with a dietitian?

Ruby Oak Nutrition is in-network with most Cigna plans, though some plans have smaller networks that we may not be a part of.

Most Cigna plans cover 3 visits per year of preventive nutrition counseling with no co-pay or co-insurance.

Most Cigna plans cover unlimited visits with an eating disorder or diabetes diagnosis. You’ll probably need to meet your deductible first, and there will likely be a co-pay or co-insurance for these visits.

If you’re a Duke employee with a Duke Cigna plan, we may or may not be in your network. As far as we know, we ARE in-network with Duke Options PPO, Duke USA PPO, Duke Advantage HDHP, and Cigna Care HMO. As far as we know, we ARE NOT in-network with Duke Select HMO or Duke Basic HMO. (We wish they would let us join all the Duke HMO networks, but they won’t!)

The only way to know your coverage for certain is to call your insurance company and verify your benefits.

Does my Medcost network plan cover nutrition counseling with a dietitian?

Ruby Oak Nutrition is in the Medcost Network, which is shared between dozens of different payers and plans. Coverage for nutrition counseling varies widely between plans, so the only way to know your coverage is to call your insurance company and verify your benefits.

Does my NC State Employee Health Plan cover nutrition counseling with a dietitian?

If you have the NC State Employee Health Plan:

The NC SHP covers unlimited nutrition counseling visits at no out-of-pocket cost.

The only way to know your coverage for certain is to call your insurance company and verify your benefits

Are you in-network with United/UMR?

No, we’re no longer in-network with United/UMR. We were in-network with United and UMR for a short time in early 2026, but it wasn’t sustainable for our practice. 

If you have a United or UMR plan, you’ll pay for nutrition counseling services out of pocket. We’re happy to provider you with a superbill that contains the appropriate coding for potential reimbursement from your insurance company. Visits will count towards your out-of-network limit and/or deductible.

What if you’re not in network with my insurance company?

We can provide you with super bills upon request. You can then submit these super bills to your insurance company for possible reimbursement. Some insurance companies may require a diagnosis for reimbursement. If this is the case with your insurance company, we’ll communicate with your physician and therapist to get any relevant diagnoses on file — we may need your help with this!

What is a Good Faith Estimate as part of the No Surprises Act?

Under the law, health care providers need to give clients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including medical nutrition therapy services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including medical nutrition therapy services.

You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service, or at any time during treatment.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate or how to dispute a bill visit, www.cms.gov/nosurprises.

What is nutrition counseling?

The goal of nutrition counseling with a dietitian is to improve your relationship with food and help you feel more confident and less stressed about what you eat. The process looks different from person to person.

If you’re struggling with an eating disorder, nutrition counseling may be about nutrition rehabilitation (making sure you get the nutrients you need) and ending disordered behaviors like restriction, binge eating, and purging. Your dietitian might give a flexible meal plan to help you eat adequately and consistently, or might have you keep a journal of your meals and/or your thoughts about food. Through the recovery process, you might work with your dietitian on overcoming food fears through exposures, challenging harmful beliefs and behaviors, and getting more comfortable with eating an adequate, varied diet.

If you’re working towards intuitive eating, nutrition counseling can help you overcome some of the challenges that come with learning to listen to your body, eat when you’re hungry, and know when you’re satisfied. Your dietitian will suggest various exercises, resources (like books and podcasts) and journal prompts for you to work through between sessions. You might also do certain exercises in session that help you feel more in touch with your body. Your dietitian can also help you come up with meal ideas and grocery lists, troubleshoot issues that come up week to week, and answer any general nutrition questions you have.

If you’re managing a nutrition-related health condition and your doctor has recommended nutrition counseling, a non-diet dietitian can help you work towards better health without restricting, dieting, or obsessing about food. In nutrition counseling, you might talk through the things that make it hard for you to eat healthfully and come up with alternative ways to do so. Your dietitian can answer any questions you have about nutrition for your particular health condition(s).

Fill out the form here to request an appointment.

What's your cancellation policy?

We require that all clients keep a credit card on file.

If you cancel a session within 24 hours of the session start time or if you no-show a session, your card on file will be billed $100 (or $50 for 25-minute appointments). There is no fee for cancelling more than 24 hours in advance, but clients who repeatedly cancel sessions may lose their standing appointment time.

Do you offer virtual appointments?

Yes, virtual telehealth appointments are available to all clients. We use Practice Better and Zoom — both HIPAA-compliant — to conduct telehealth appointments.

Fill out the form here to request an appointment.

Do you offer in-person appointments?

Yes, in-person appointments are available at our two offic spaces:

Downtown Raleigh Office, 219 S. East Street, Raleigh, NC, 27601

Durham Office: 3001 Academy Rd, Ste 130, Durham, NC, 27707

Fill out the form here to request an appointment.

Do I need a referral for nutrition counseling?

In most cases, you don’t need a referral for nutrition counseling. However, in order to submit claims to your insurance plan or provide you with a superbill for potential out-of-network reimbursement, we might need some information from your primary care provider (or your therapist, if you’ve been diagnosed with an eating disorder) in order to fill out the required documentation. We’ll discuss this with you prior to your initial session if it’s necessary.

What is a non-diet approach? Is it just for eating disorders and disordered eating?

A non-diet approach to health and nutrition is all about eating in a way that’s nourishing but not restrictive. An anti-diet approach is also weight-inclusive, which means that it’s never about weight loss or the number on the scale. We use the principles of Health at Every Size® to guide the nutrition counseling process.

Non-diet nutrition counseling will help you feel more confident about food and your body. We’ll focus on making sure you’re eating adequately throughout the day and getting a variety of nutrients, but we’ll never label foods as “good” or “bad.” Food is just food — it doesn’t have a moral value, and there’s never any reason to feel guilty for eating one thing or virtuous for eating another. All foods provide some nutrition, and it’s possible to eat in a way that you love while also supporting your health.

Our approach isn’t just for eating disorders and disordered eating. The principles of hunger, fullness, satisfaction, variety, and gentle nutrition can be applied to everyone and all health conditions.

How do I verify my insurance coverage?

To verify that your insurance covers nutrition counseling, call the number on the back of your insurance card and ask the following questions listed below (sorted by insurance provider). Be sure to write down answers, along with the reference number, somewhere that you can refer back to later.

 

Insurance Questions for Aetna and Meritain

The representative may ask for our national provider identifier (NPI):

Ruby Oak Nutrition (or Christine Byrne Nutrition LLC) NPI: 1629731419

  1.  Is Christine Byrne Nutrition DBA Ruby Oak Nutrition an in-network provider with my plan?
  2. Does my plan cover outpatient nutrition therapy CPT codes 97802 (medical nutrition therapy – assessment) and 97803 (medical nutrition therapy – follow up)?
  3. Do I have 10 nutrition counseling visits covered under Aetna’s “Healthy Diet Counseling” benefit? What criteria do I need to meet to qualify for this benefit?
  4. Do I have an additional 16 nutrition counseling visits covered under Aetna’s “Obesity Counseling” benefit? What criteria do I need to meet to qualify for this benefit?
  5. Do I have coverage for services provided via telehealth?
  6. Do I need a physician referral for nutrition counseling?
  7. If relevant: Do I have coverage for nutrition counseling with an eating disorder diagnosis? If so, how many visits are covered per year? Do I need to meet my deductible before my plan will pay for sessions? Is there a co-pay or co-insurance for sessions?
  8. If relevant: Do I have coverage for nutrition counseling with a diagnosis of diabetes, prediabetes, gestational diabetes, high blood pressure, or high cholesterol? If so, how many visits are covered per year? Do I need to meet my deductible before my plan will pay for sessions? Is there a co-pay or co-insurance for sessions?
  9. What month does the policy year renew?
  10. What month does the policy year renew?
  11. Are there any restrictions and/or limitations to my coverage?

Write down and keep the reference number for your call.

Insurance Questions for Blue Cross Blue Shield

The representative may ask for our national provider identifier (NPI):

Ruby Oak Nutrition (Or Christine Byrne Nutrition LLC) NPI: 1629731419

  1. Is Ruby Oak Nutrition currently an in-network provider for my plan?
  2. Does my plan cover outpatient nutrition therapy CPT codes 97802 (medical nutrition therapy – assessment) and 97803 (medical nutrition therapy – follow up)?
  3. Do I have any nutrition counseling visits covered under the preventative care portion of my plan, (ICD-10 code z71.3)? How many?
  4. Do I have coverage for services provided via telehealth?
  5. Do I need a physician referral for nutrition counseling?
  6. If relevant: Do I have coverage for nutrition counseling with an eating disorder diagnosis? If so, how many visits are covered per year? Do I need to meet my deductible before my plan will pay for sessions? Is there a co-pay or co-insurance for sessions?
  7. If relevant: Do I have coverage for nutrition counseling with a diagnosis of diabetes, prediabetes, gestational diabetes, high blood pressure, or high cholesterol? If so, how many visits are covered per year? Do I need to meet my deductible before my plan will pay for sessions? Is there a co-pay or co-insurance for sessions?
  8. What month does the policy year renew?
  9. Are there any restrictions and/or limitations to my coverage?

Write down and keep the reference number for your call.

Insurance Questions for Cigna

The representative may ask for our national provider identifier (NPI):

Ruby Oak Nutrition (or Christine Byrne Nutrition LLC) NPI: 1629731419

  1. Is Christine Byrne Nutrition DBA Ruby Oak Nutrition an in-network provider with my plan?
  2. Does my plan cover outpatient nutrition therapy CPT codes 97802 (medical nutrition therapy – assessment) and 97803 (medical nutrition therapy – follow up)?
  3. How many preventitive nutrition counseling visits do I get per year with the diagnosis code z71.3?
  4. Do I have coverage for services provided via telehealth?
  5. Do I need a physician referral for nutrition counseling?
  6. If relevant: Do I have coverage for nutrition counseling with an eating disorder diagnosis? If so, how many visits are covered per year? Do I need to meet my deductible before my plan will pay for session? Is there a co-pay or co-insurance for sessions?
  7. If relevant: Do I have coverage for nutrition counseling with a diagnosis of diabetes, prediabetes, gestational diabetes, high blood pressure, or high cholesterol? If so, how many visits are covered per year? Do I need to meet my deductible before my plan will pay for sessions? Is there a co-pay or co-insurance for sessions?
  8. What month does the policy year renew?

Write down and keep the reference number for your call.

Insurance Questions for Medcost

The representative may ask for our national provider identifier (NPI):

Ruby Oak Nutrition (or Christine Byrne Nutrition LLC) NPI: 1629731419

  1. Is Christine Byrne Nutrition DBA Ruby Oak Nutrition an in-network provider with my plan?
  2. Does my plan cover outpatient nutrition therapy CPT codes 97802 (medical nutrition therapy – assessment) and 97803 (medical nutrition therapy – follow up)?
  3. How many preventive nutrition counseling visits do I get per year with the diagnosis code z71.3?
  4. Do I have coverage for services provided via telehealth?
  5. Do I need a physician referral for nutrition counseling?
  6. If relevant: Do I have coverage for nutrition counseling with an eating disorder diagnosis? If so, how many visits are covered per year? Do I need to meet my deductible before my plan will pay for session? Is there a co-pay or co-insurance for sessions?
  7. If relevant: Do I have coverage for nutrition counseling with a diagnosis of diabetes, prediabetes, gestational diabetes, high blood pressure, or high cholesterol? If so, how many visits are covered per year? Do I need to meet my deductible before my plan will pay for sessions? Is there a co-pay or co-insurance for sessions?
  8. What month does the policy year renew?

Write down and keep the reference number for your call.