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Frequently Asked Questions

Please read the following information to better understand UPMC Lifestyle Medicine. This information answers Frequently Asked Questions (FAQs) about Lifestyle Medicine at UPMC including scheduling and insurance coverage for our services.

What is Lifestyle Medicine? 

Lifestyle Medicine shifts the focus from the doctor treating your symptoms to you taking control of your health. Nearly 80% of all chronic diseases develop due to lifestyle choices. Lifestyle change requires time, consistency, and support. Our Lifestyle Medicine team can help you recognize behaviors which may be worsening your symptoms and adopt healthier behaviors that can improve your health and how you feel overall. It is possible to manage, improve, and even prevent many chronic diseases (like diabetes, obesity, heart disease, some cancers, and more) by focusing on behaviors associated with these six categories of Lifestyle Medicine: 

  1. Nutrition that is whole-food and plant-predominant 
  2. Restorative and restful sleep 
  3. Physical activity and exercise 
  4. Stress management. 
  5. Avoidance of risky substances 
  6. Positive relationships and social connection

UPMC Lifestyle Medicine requires a referral for services which are made electronically by a referring provider. Once our team receives your referral, we will reach out to you through messaging in the MyUPMC app. 

Treatment requires an active MyUPMC account. If you do not use the MyUPMC app or browser, please go the the MyUPMC website or call 1-866-884-8579.

UPMC Lifestyle Medicine treats adults aged 18 and older.

How do I make an appointment to discuss Lifestyle Medicine?

UPMC Lifestyle Medicine only schedules telemedicine/virtual appointments. All appointments are accessed through the MyUPMC app. To get help and confirm your MyUPMC app is active, please go the the MyUPMC website or call 1-866-884-8579.

How can I schedule and communicate with Lifestyle Medicine?

Communicating through the MyUPMC app with messages is the preferred and fastest way to schedule, reschedule, and talk to us. Phone calls and emails may take 1-3 business days for a response.

Please respond promptly to our messages. After two weeks, you can no longer reply. If you want to reach us but cannot send Lifestyle Medicine a message, you will need to send a message to your primary provider and ask them to forward it to Lifestyle Medicine.

What are the services offered in Lifestyle Medicine?

UPMC Lifestyle Medicine is a specialization. Our team includes board-certified Lifestyle Medicine physicians, physician assistants, a dietitian, and a health coach. Our providers will make recommendations for services based on your referral, your medical history, and your needs. Our programs include individual appointments and group appointments, which are called group medical visits. We also offer dietitian services and will begin health coaching services in 2024.  

Group medical visits are a newer way to manage health and allow for learning from other people (sharing struggles and successes) who are working through similar health situations. Each group has a group leader (a physician/expert on the topic) who provides education and teaches you ways to improve your health while encouraging questions and conversations among those in the group. Research shows that group medical visits increase confidence in managing your health, allow more time with your provider to ask and discuss questions, and teach positive ways to successfully improve lifestyle choices. This results in your ability to better manage your health.  

What can I expect during an appointment?

Individual Lifestyle Medicine Assessment & Follow-ups

Assessment: One-on-one appointment with a Lifestyle Medicine physician or physician assistant. This appointment specifically identifies health problems and challenges, creates a plan of care, and establishes goals to improve your health. Assessments are recommended for some, but not all, patients referred to UPMC Lifestyle Medicine 

Note: Any one-on-one appointment with a Lifestyle Medicine physician/physician assistant is not for general medical care, but the appointment may address lifestyle factors that influence chronic disease, health and well-being. 

Prior to your one-on-one appointment, you will receive a link to a survey to complete through a message in the MyUPMC app. At the end of your assessment, your provider will discuss scheduling follow-up visits and participating in other services that meet your needs and interests.  

Are there group medical visits?

Groups may include 8-12 participants with similar health needs. Participants are encouraged to share only what he/she is comfortable sharing. Confidentiality is reviewed at the start of sessions to help everyone feel more comfortable with participation.   

A group leader (physician, physician assistant, or other qualified healthcare professional trained in Lifestyle Medicine such as a health coach or dietitian) will discuss a topic that facilitates conversations and provides education around how the topic of the group visit impacts the health of the individual participants, and the leader works to identify and provides tools and techniques to increase awareness and modifications of behaviors that are known to help improve symptom management, disease progression, and even disease prevention.

Group Visits Frequency and Duration

UPMC Lifestyle Medicine has a variety of Group Medical Visits that cover different topics and diagnosis.

Visits are scheduled differently for each topic, but there are generally two types of group visits:

  • Four visits that meet every other week (bi-weekly for a total of 4 visits)
    • These visits are generally 60-75 minutes per session
  • One-time only Group Visits or one visit on a specific topic
    • These visits are generally 60 to 90-minutes per session
Are there services that dietitians provide?

Our dietitian services include Medical Nutrition Therapy and Lifestyle Nutrition Counseling. Our Lifestyle Medicine team will help determine which dietitian service is best for your needs. Insurance coverage for dietitian services varies widely. Please read the insurance information on our website and with any of our scheduling messages to better understand your insurance coverage.

Medical Nutrition Therapy

  • Direct referral to a dietitian with a diagnosis or multiple diagnoses from the referring provider.
  • An individualized and specific assessment and treatment plan is created and delivered by the dietitian.
  • Insurance coverage depends on the diagnosis and your specific insurance plan.
    • Some but not all insurance plans provide coverage for Medical Nutrition Therapy.
    • Many insurance plans that cover Medical Nutrition Therapy have limitations on how many sessions or hours you can participate 
    • Some insurance plans have additional costs associated with Medical Nutrition Therapy such as payment toward deductible, copayments, co-insurance, etc. Please read about insurance to learn more.

Lifestyle Nutrition Counseling 

A team approach with a physician/physician assistant and a dietitian. All dietitian sessions are supervised by the primary Lifestyle Medicine provider. All Lifestyle Nutrition Counseling medical visits are considered office visits with your primary provider. 

Initial individual appointment: At first, an appointment is scheduled with a Lifestyle Medicine physician/physician assistant (known as a Lifestyle Medicine Assessment). You will create goals and a plan of care specific to your health problems, based on the six categories of Lifestyle Medicine which includes nutrition 

Follow-up appointments: These are scheduled with the dietitian (individually or in a group) who will work on this plan of care with you and provide education on healthy food choices, forming healthy eating habits, how lifestyle choices with sleep, stress, physical activity and exercise, substances, and socialization impact your health in relation to food, and more to help you meet your goals.

Expectations including consent, confidentiality, and attendance

Group Informed Consent 

Group Medical Visits (GMVs) are a unique approach to treating chronic disease. This dynamic includes a relationship with a group of people who are likely experiencing similar health concerns who give and receive help from one another while being guided by a qualified healthcare professional (known as a group facilitator). UPMC Lifestyle Medicine attempts to create an environment where honest, interpersonal exploration will occur that will benefit all members. To create this environment, we request certain guidelines be agreed and followed by each participant. This includes:

Confidentiality

  • GMVs are effective because participants feel safe to share private information in a confidential atmosphere. It is important that every member of the group agrees to uphold the confidentiality of a therapeutic setting. 
  • Participants agree to keep names and identities of other group members confidential.

Attendance

  • GMVs are successful when there is regular attendance, for the benefit of the individual and the entire group. Each GMV is a medical visit.   
  • If you cannot attend one of the visits, please contact your provider via messaging to discuss scheduling an appointment to review any missed content.  
  • Please arrive on time and stay for the entire session.  
  • While all GMVs in UPMC Lifestyle Medicine are virtual, it is expected that your camera be on so faces can be seen.

Active Participation

  • Members of effective GMVs actively share thoughts, reactions, challenges, and successes during group visits to facilitate behavior change. 
  • Participation does not necessarily mean talking. It can also mean actively listening to what other participants are saying and sharing.  
  • It is requested that you share what is comfortable for you and actively listen to other participants. Please understand the following:  
    • Each participant may share as much or as little as he/she feels comfortable with.  
    • Each participant will share information in different ways.  
    • Each participant will be comfortable with different levels of disclosure.

Confidentiality and Privacy

  • Because group visits involve patients potentially disclosing private medical and social information, participants in a group medical visit must agree to respect the privacy and confidentiality of all participants.  
Insurance Questions for Group Medical Visits, Lifestyle Medicine Assessment and Nutrition Counseling
  1. Call the customer service number on your medical insurance card. 
  2. Explain you have been referred for medical office visits and you want to confirm coverage and potential costs for services. 
  3. Ask if our services are “in-network”. 
    1. Our facility name is “UPP Family Medicine" and our NPI is 1740248020 
  4. All visits are telemedicine visits, so ask if you have coverage for telemedicine. 
  5. Ask if office visits are covered. 
    1. Common CPT codes include 99202-99205 for a first visit in the department. Common CPT codes for follow-up visits are 99211-99215. 
      1. Note: you will likely be seen more than once, so both of the above CPT codes will apply 
  6. Insurance will likely not be able to tell you if our department is considered as a specialist visit or a primary care/PCP visit. Each insurance company views our department differently. 
    1. Lifestyle Medicine is part of the Department of Family Medicine.  
    2. Our providers are not your primary care team/PCP/family medicine provider. As a result, your insurance company may or may not consider UPMC Lifestyle Medicine as a specialization.  
    3. We suggest asking your insurance agent to provide you with costs for both a primary care visit AND as a specialist visit. 
    4. Neither your insurance agent nor our UPMC Lifestyle Medicine team will know if we will be treated as a specialist or primary care provider until a bill is submitted. 
  7. Finally, ask what your financial responsibility is: 
    1. Do you have a deductible that needs to be met? 
    2. Do you have a co-pay? 
    3. Do you have a co-insurance or any other costs you need to be aware of?

Each plan is different, so please make sure you understand your financial responsibility. 

If insurance coverage or costs are limiting your participation with Medical Nutrition Therapy, please tell us so our Lifestyle Medicine team can discuss alternative options to address your nutritional needs. 

Insurance Questions for Medical Nutrition Therapy from a Dietitian
  1. Call the customer service phone number on your insurance card 
  2. Ask about insurance coverage for Medical Nutrition Therapy 
  3. Medical Nutrition Therapy is provided by a registered dietitian/licensed dietitian nutritionist (RD/LDN) 
  4. Medical Nutrition Therapy requires a referral and a diagnosis. 
    1. Your referral to UPMC Lifestyle Medicine will include at least one diagnosis, which is the reason for referral.  
    2. Your insurance will need to know what your diagnosis is before they can determine your coverage.  
      1. UPMC Lifestyle Medicine provides you with your diagnosis in a message asking about scheduling for Medical Nutrition Therapy services. Find the diagnosis under the section bolded “INSURANCE.” The diagnosis is formatted as a letter and a number. For example, it might look like this: "Your Diagnosis is: E66.9"
  5. This diagnosis will be different for each person. Your Lifestyle Medicine providers are aware that Medical Nutrition Therapy is only covered for certain diagnoses. 
    1. In order to determine if your insurance offers coverage for Medical Nutrition Therapy you will need to know your diagnosis. If you do not have a diagnosis when you call your insurance company, use the code in the example above “E66.9” as this code is covered by many insurance plans.  
    2.  Note: Once you know what your diagnosis for Medical Nutrition Therapy is, please confirm that code is covered by your insurance.
  6. Ask your insurance company if the following Medical Nutrition Therapy codes (CPTs) are covered services: 
    1. 97802 (first visit)  
    2. 97803 (all follow-up visits)
  7. After all of the above has been determined, confirm the following: 
    1. Is Medical Nutrition Therapy a covered service in your insurance plan? 
    2. Is there a limit to the number or the hours of medical nutrition therapy visits you can have in one year?  
    3. Do you have any out-of-pocket expenses with these visits such  
      1. Payment toward deductible: 
      2.  Co-payment per session 
      3. Co-insurance per session

Each plan is different, so please make sure you understand your financial responsibility. 

If insurance coverage or costs are limiting your participation with Medical Nutrition Therapy, please tell us so our Lifestyle Medicine team can discuss alternative options to address your nutritional needs.