Medicare obesity counseling outreach

Medicare covers a year of intensive behavioral counseling for obesity, delivered in primary care, at no cost to the patient when the provider accepts assignment. That makes it a natural service for outreach from family medicine, internal medicine, geriatrics and OB-GYN practices, and from nurse practitioner and physician assistant led primary care clinics. It is also a service where the wrong words cost trust fast. A text that calls someone obese, an ad that promises a number of pounds, or a before and after photo can turn a covered preventive benefit into a page the FTC, Google and your own patients would read as a weight loss pitch. This guide covers who qualifies under the Medicare rule, the visit schedule and the six month check, the billing codes and limits that shape the program, what the Task Force says for adults and for children, and how to invite patients without shame or promises.

Related topics have their own guides and are not repeated here. Clinic marketing for weight care is covered in our guide to weight loss clinic marketing, surgery in our guide to bariatric surgery marketing, the lifestyle program for prediabetes in our guide to diabetes prevention program marketing, nutrition services in our guide to dietitian marketing, and photo and testimonial rules in our guide to patient testimonials and before and after photos.

This is general information, not legal, billing or medical advice. Sources cited were checked on October 30, 2026: the CMS National Coverage Determination for Intensive Behavioral Therapy for Obesity (210.12), the Medicare Claims Processing Manual, Chapter 18, section 200 (chapter revision 13709, issued April 2, 2026), and the Medicare.gov page Obesity behavioral therapy, all read through archived copies; the USPSTF final recommendations Weight Loss to Prevent Obesity-Related Morbidity and Mortality in Adults: Behavioral Interventions (September 18, 2018) and High Body Mass Index in Children and Adolescents: Interventions (June 18, 2024), also read through archived copies; 42 U.S.C. 300gg-13 and 1320a-7a, 16 CFR 255.2, 45 CFR 164.502, 47 CFR 64.1200 and 15 U.S.C. 45. Coverage rules, codes and Medicare Advantage plan terms change, and state rules on telehealth, scope of practice and minors’ care differ. Have your billing advisor and a health care attorney review the program before you launch.

What Medicare covers, in the words CMS uses

The National Coverage Determination for Intensive Behavioral Therapy for Obesity, 210.12, has applied to claims with dates of service on or after November 29, 2011. It covers intensive behavioral therapy for obesity, which it defines as a body mass index (BMI) of 30 or higher, for the prevention or early detection of illness or disability. The therapy has three parts: screening for obesity by measuring BMI, a dietary (nutritional) assessment, and intensive behavioral counseling and behavioral therapy to promote sustained weight loss through high intensity interventions on diet and exercise.

The rule says the counseling should be consistent with the five A framework highlighted by the Task Force: assess behavioral health risks and the factors that affect the patient’s choice of goals, advise with clear, specific and personal advice, agree on goals and methods based on the patient’s interest in and willingness to change, assist with behavior change techniques and support, and arrange follow-up contacts, including referral to more intensive or specialized treatment.

The Medicare.gov page Obesity behavioral therapy says Part B covers it for people with a BMI of 30 or more, that the counseling comes from a primary care doctor or other primary care provider in a primary care setting, such as a doctor’s office, and that the person pays nothing if their primary provider accepts assignment. It also says the person must meet certain weight loss requirements for Medicare to keep covering the counseling. That page also describes drug coverage changes; this guide covers counseling only and names no medicine.

Who qualifies, and where the visits must happen

The coverage rule names four conditions. The person has a BMI of 30 or higher. They are competent and alert at the time the counseling is given. The counseling is furnished by a qualified primary care physician or other primary care practitioner. And it happens in a primary care setting.

The rule defines a primary care setting as one with integrated, accessible health care by clinicians accountable for addressing a large majority of personal health care needs, building a sustained partnership with patients and practicing in the context of family and community. It lists settings that do not count: emergency departments, inpatient hospital settings, ambulatory surgical centers, independent diagnostic testing facilities, skilled nursing facilities, inpatient rehabilitation facilities and hospices.

The Claims Processing Manual turns that into billing edits. Professional claims are allowed only from these provider specialties on the enrollment record: general practice, family practice, internal medicine, obstetrics and gynecology, pediatric medicine, geriatric medicine, nurse practitioner, certified clinical nurse specialist and physician assistant. They are allowed only with these place of service codes: 11 (physician’s office), 19 (off campus outpatient hospital), 22 (on campus outpatient hospital), 49 (independent clinic) and 71 (state or local public health clinic). Claims from other specialties or places are denied.

If your practice is a specialty clinic, a stand-alone weight loss clinic or a med spa, this benefit does not fit your setting. Do not advertise it as something you bill.
Registered dietitians are not on the specialty list. If a dietitian is part of your program, ask your billing advisor and your Medicare contractor how their work can be billed before you describe it to patients; our dietitian guide covers medical nutrition therapy, a separate benefit.
Medicare Advantage plans have their own network and referral rules. Ask each plan before you tell its members the visits cost nothing.

The visit schedule and the six month check

The coverage rule sets the schedule, and it is the core of any outreach plan:

One face-to-face visit every week for the first month.
One face-to-face visit every other week for months 2 through 6.
One face-to-face visit every month for months 7 through 12, if the person meets the weight loss requirement in the first six months.

At the six month visit, the clinician must reassess obesity and determine how much weight was lost. To be eligible for the monthly visits in months 7 through 12, the person must have lost at least 3 kg (about 6.6 pounds) during the first six months. For people who did not, the rule says a reassessment of their readiness to change and their BMI is appropriate after an additional six month period.

That 3 kg figure is a coverage condition, not a result to advertise. It tells the practice when it can keep billing; it does not tell a reader what they will lose. Keep it out of ads, subject lines and landing page headlines, and explain it to enrolled patients in person, as part of the plan their clinician makes with them.

The Claims Processing Manual adds a cap: effective January 1, 2015, the codes for this service can be billed for no more than 22 sessions in a 12-month period, and the Medicare coinsurance and Part B deductible are waived for this preventive service. A calendar that books every visit in the rule fits under that cap; extra sessions beyond it are denied.

Billing codes searchers ask about

The Claims Processing Manual names two HCPCS codes. G0447 is face-to-face behavioral counseling for obesity, 15 minutes, effective November 29, 2011. G0473 is face-to-face behavioral counseling for obesity, group (2 to 10 people), 30 minutes, effective January 1, 2015. Each is billed with one of the ICD-10-CM BMI codes Z68.30 through Z68.39 or Z68.41 through Z68.45. For institutional claims, the manual lists types of bill 13x, 71x, 77x and 85x for G0447, and 13x and 85x for G0473.

These codes matter for marketing in two ways. First, a group session is a real option under the rule, and a group program can be described on a page by its schedule and who leads it. Second, a group session puts patients in a room with each other. Before a patient joins one, tell them who else will be there and what is shared, and let them choose individual visits instead. Our annual wellness visit guide covers how to raise a separate concern on the same day without surprising the patient with a bill.

Codes, bill types and edits change. Confirm them with your Medicare contractor and your billing advisor each year before you print anything that names them.
Do not put codes on patient-facing pages. A patient needs to know the visit is covered and when, not how it is billed.

What the Task Force says for adults

The U.S. Preventive Services Task Force recommends that clinicians offer or refer adults with a BMI of 30 or higher to intensive, multicomponent behavioral interventions, with a grade of B. The statement is dated September 18, 2018. It describes the interventions it reviewed as lasting 1 to 2 years, with the majority offering 12 or more sessions in the first year, and focused on problem solving, self-monitoring of weight, peer support and relapse prevention.

We checked whether the recommendation is being redone. On October 30, 2026, the archived copy of the adult recommendation said the topic is being updated and linked to a draft update on behavioral counseling to promote a healthy diet, physical activity and weight loss to prevent cardiovascular disease in adults. A page that quotes the 2018 statement should be checked again when that update is final.

For private coverage, 42 U.S.C. 300gg-13(a)(1) requires plans subject to the rule to cover, with no cost sharing, items and services with an A or B rating in the current Task Force recommendations. Certain plans are not subject to the rule, and plan terms decide how the benefit is delivered, so a page should say “your plan may cover it” and offer to check, not promise a no-cost program to every reader.

Children and teens: a separate recommendation, a separate message

Medicare’s benefit is for adults on Medicare. For children, the Task Force’s June 18, 2024 recommendation says clinicians should provide or refer children and adolescents 6 years or older with a high BMI, at or above the 95th percentile for age and sex, to comprehensive, intensive behavioral interventions, with a grade of B. It says that to achieve benefit, these children need intensive interventions of 26 or more contact hours, and that effective programs had several components, including sessions for both the parent and the child and group sessions in addition to individual or family sessions.

For pediatric and family practices, that means the outreach goes to a parent or guardian, not to the child, and it describes a family program, not a diet. Our well-child visit guide covers how to address parents. Who counts as a parent or guardian, and what a teen can consent to alone, is set by state law; 45 CFR 164.502(g) points to that law for personal representatives.

Do not send a child or teen any message about weight or BMI. Address the parent, by name, through the contact they chose.
Describe the program by what the family does together, such as cooking, activity and sleep, with the hours and who leads it.
Do not compare children to each other, show children’s photos or tell a weight story about a child, even with consent.

Words that invite, and words that push people away

Outreach for this benefit works only if people feel invited, not judged. The rule’s own language is clinical, and that is right in a chart and wrong in a text. Use plain, respectful words in anything a patient reads, and save BMI and obesity for the conversation with their clinician.

Say “a year of support for healthy eating and activity” or “weight and health counseling”, not “obesity program” or “for obese patients”.
Lead with what the program is: visits with their own clinician, a plan they agree to, and follow-up at a pace set by Medicare’s schedule.
Do not promise a number of pounds, a size, a date or a body. Do not write “lose weight fast” or anything like it.
Do not use before and after photos or weight loss testimonials for this service. Under 16 CFR 255.2(b), an ad with a consumer’s experience on a central attribute will likely be read as what people will generally achieve; if you cannot substantiate that, the ad should clearly and conspicuously disclose the generally expected performance, and you need substantiation for that too. Our testimonials guide covers the rule.
Under 15 U.S.C. 45, claims must be true and not misleading. A page about counseling should not suggest a medicine, a device or a promised outcome comes with it.

Reminder texts, calls and letters

The visit schedule makes this a reminder-heavy service: four visits in the first month and two a month for five months after that. The FCC rule at 47 CFR 64.1200(a)(9)(iv) exempts certain healthcare calls and texts to a wireless number from the prior consent requirement, including appointment and exam confirmations and reminders. The conditions include sending only to the wireless number the patient provided, stating the provider’s name and contact information, no telemarketing, solicitation or advertising, no more than one message per day and three per week, an opt-out in each message, and honoring opt-outs immediately. The rule also says the messages must comply with HIPAA privacy rules and be concise, generally 160 characters or less for a text. Our text reminder guide covers the setup.

A first invitation to a patient who has not enrolled is a different message from a reminder of a booked visit. If it reads as a sales pitch, it is outside the reminder exemption. Send the first invitation from the patient’s own clinician, at a visit or through the portal, and keep texts for visits the patient has already booked.

Sample reminder text: “[Practice name]: reminder of your visit with [clinician name] on [date] at [time]. Call [phone] to change it. Reply STOP to opt out.” Sample portal invitation: “[Clinician name] would like to talk with you about a Medicare benefit that covers a year of support for healthy eating and activity, with regular visits here. If you are interested, reply here or call [phone], [days and hours].” Neither names a weight, a BMI or a diagnosis.

Build the invitation list from your own records and your clinicians’ judgment, not from a bought list. Our guide to buying patient leads explains why.
Put the full visit schedule in the patient’s hands at enrollment, so reminders confirm visits they already know about.
Do not text weights, BMI or progress. Those belong in the visit or the portal.

Ads, pages and tracking

For Google Ads, target place and search terms such as obesity counseling Medicare or weight counseling near me, not patient lists; Google’s personalized advertising policy lists health among its restricted categories, so do not build audiences from health conditions or address the reader as someone with a weight problem. Our weight loss clinic guide covers the ad platforms’ weight loss rules.

Booking pages for this service should not send page titles, form answers or appointment types to ad or analytics platforms. HHS has explained how online tracking technologies can disclose health information; our guide to tracking pixels on practice websites covers it. Offering something of value to a Medicare or Medicaid beneficiary to choose your practice, such as a gift card for enrolling or a free scale, can bring in 42 U.S.C. 1320a-7a(a)(5), so have counsel review any incentive. Our guide to marketing to Medicare patients covers the inducement rules.

The service page itself should say what the benefit is, in Medicare’s terms and with the source, who qualifies, where the visits happen and how they are scheduled, what it costs with and without assignment, and who to call. Make the page and the booking form usable with a keyboard and a screen reader.

Illustration: two counseling pages

Illustration: a page reads “Medicare will pay for your weight loss! Obese? Lose 20 pounds in 12 weeks with our free Medicare program. Sign up today and get a free scale.” It labels the reader, promises a result, says free without terms, offers a gift to Medicare patients and turns a coverage condition into an ad.

Illustration: a second page for the same practice reads “Medicare Part B covers a year of counseling for healthy eating and activity for people with a BMI of 30 or more, with visits at our office led by your primary care clinician. Visits are weekly in the first month and every other week through month six, with monthly visits after that if Medicare’s requirements are met. You pay nothing if your provider accepts assignment, and we can check your plan for you. Ask your clinician at your next visit, or call [phone], [days and hours].” It states the benefit as Medicare writes it, explains the schedule, and makes no promise about weight.

Checklist before a counseling campaign goes live

Your setting is a primary care setting under NCD 210.12, and the clinicians who will bill are on the specialty list in the Claims Processing Manual.
The page states the benefit, eligibility and schedule as CMS and Medicare.gov write them, with the source and the date checked.
Cost wording says the person pays nothing if the provider accepts assignment, and Medicare Advantage members are told to let you check their plan.
No page, ad or message promises pounds, sizes or dates, and the 3 kg coverage condition never appears in marketing.
No before and after photos or weight testimonials appear for this service.
Invitations come from the patient’s clinician; texts are for booked visits, stay within one per day and three per week, carry a STOP opt-out and never include a weight or BMI.
Group sessions are explained before a patient joins, with an individual option.
Outreach for children goes to parents, describes a family program and follows the 2024 Task Force recommendation as written.
No gift, scale or incentive is offered to Medicare patients without counsel’s review, and no tracking tool on the booking page sends the appointment type to an ad platform.
Someone owns a date to recheck the adult Task Force recommendation when its update is final, and the codes each January.

How we help

We build websites, local search, Google Ads, patient lead generation and AI front desk tools for independent practices and health businesses, including family medicine, internal medicine, geriatrics and nurse practitioner led clinics. For obesity counseling outreach, that means a site that explains the Medicare benefit in CMS’s own terms, booking pages that keep the appointment type away from ad platforms, and reminders for a year of visits that stay within the federal text rules and never mention a weight. Our tools are built with HIPAA in mind. We confirm in writing what a BAA covers before any patient information flows through a tool, and if it is not covered, we do not route patient information through it.

Does Medicare cover obesity counseling?

Yes. Under NCD 210.12, Part B covers intensive behavioral therapy for people with a BMI of 30 or higher, given by a qualified primary care physician or other primary care practitioner in a primary care setting. Medicare.gov says the person pays nothing if their primary provider accepts assignment.

What visit schedule does Medicare cover for obesity counseling?

The rule covers weekly visits in the first month, visits every other week in months 2 through 6, and monthly visits in months 7 through 12 if the person lost at least 3 kg in the first six months. The Claims Processing Manual caps billing at 22 sessions in a 12-month period.

What are the Medicare codes for obesity counseling?

G0447 is individual face-to-face behavioral counseling for obesity, 15 minutes. G0473 is group counseling for 2 to 10 people, 30 minutes. Each is billed with an ICD-10-CM BMI code from Z68.30 to Z68.39 or Z68.41 to Z68.45. Confirm codes with your Medicare contractor each year.

Can a weight loss clinic or med spa bill Medicare for this counseling?

Only primary care settings qualify, and the Claims Processing Manual allows claims only from listed primary care specialties, nurse practitioners, clinical nurse specialists and physician assistants, at listed places of service. Specialty clinics and med spas do not fit the rule.

What does the Task Force recommend for children?

The USPSTF (June 18, 2024) recommends that clinicians provide or refer children and adolescents 6 years or older with a BMI at or above the 95th percentile to comprehensive, intensive behavioral interventions of 26 or more contact hours, grade B.

Can we advertise how much weight patients lose?

No. The 3 kg figure is a Medicare coverage condition, not a promised result. Testimonials and before and after photos are read as what people will generally achieve under 16 CFR 255.2(b), and claims must be true and substantiated under 15 U.S.C. 45.

Obesity counseling outreach under Medicare: who qualifies, the visit schedule, billing codes and respectful messages