Letter of Medical Necessity for your HSA/FSA
If you plan to use HSA/FSA funds for nutrition consultation sessions, I strongly recommend keeping a Letter of Medical Necessity or physician referral in your records.
This page is designed to make the process easier.
Steps to get your Letter of Medical Necessity (LMN)
Your HSA/FSA administrator may ask for documentation showing that your nutrition consultation is connected to care for a specific physician-diagnosed condition. This may happen when you submit documentation, if a claim is questioned, or in the event of an audit.
Clean Balanced Wellness cannot determine whether your HSA/FSA plan will approve a claim, guarantee reimbursement, or provide tax advice. Your HSA/FSA administrator is the best source for your specific plan requirements.
Step 1: Contact your HSA/FSA administrator
Before using HSA/FSA funds, contact your plan administrator and ask:
– Are nutrition consultation services with a nutritionist eligible under my plan?
– What documentation do I need?
– Do I need a Letter of Medical Necessity, physician referral, diagnosis code, CPT code, or itemized receipt?
– You may want to write down the answers or save a screenshot/email for your records.
Step 2: Choose your doctor
The Letter of Medical Necessity or referral should come from your physician (MD or DO only).
This may be your:
– primary care physician
– endocrinologist
– functional medicine physician
– OB/GYN
– gastroenterologist
– cardiologist
– or another physician familiar with your diagnosis and health history
Step 3: Contact the doctor’s office
Before sending a written request, contact your doctor’s office and ask how they prefer to handle requests for a Letter of Medical Necessity or referral for nutrition consultation.
You can say:
“I’m considering a 12-week nutrition program and want to use HSA/FSA funds for the nutrition consultation sessions. My HSA/FSA administrator may request a Letter of Medical Necessity or physician referral. What is the best way to request this from the doctor?”
Step 4: If your doctor does not write LMNs, ask what they can provide instead
Some doctors do not write Letters of Medical Necessity. That’s okay.
Ask whether they can provide one or more of the following instead:
– a referral for nutrition consultation
– a brief note stating nutrition consultation is recommended
– a recent visit summary showing your diagnosis
– a problem list with diagnosis codes
– documentation from your chart showing the diagnosed condition
You can then ask your HSA/FSA administrator whether that documentation is sufficient.
Step 5: If the office needs a written request, use the sample message
You don’t need to write your own message from scratch.
Copy the sample message in the bottom section of this page. Fill in the blanks, and send it to your physician through their patient portal, email, or office messaging system.
Attach the physician letter template if that’s helpful. This document includes a simple template your physician may use, edit, place on office letterhead, or replace with their own version. Your physician does not need to use this exact wording.
The important thing is that the letter or referral comes from your physician and connects nutrition consultation to your diagnosed medical condition.
Step 6: Save the completed documentation
Once you receive the completed letter, referral, or other documentation, save a copy for your records.
Recommended places to save it:
– your computer
– your patient portal
– your HSA/FSA records
– a folder with your nutrition consultation receipts
– your Clean Balanced Wellness client portal
Step 7: Keep your receipts
For each eligible nutrition consultation session, Clean Balanced Wellness will provide an itemized receipt.
Please keep copies of:
– your Letter of Medical Necessity or physician referral
– your nutrition consultation receipts
– any lab receipts from the lab provider
– any communication from your HSA/FSA administrator
If You Feel Overwhelmed
Start with just one step:
Choose the doctor who is most familiar with the condition you want nutrition support for.
Then contact that doctor’s office and ask how they handle requests for a Letter of Medical Necessity or referral.
Letter Templates
No need to compose from scratch.