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The new world (2025-2026): Medicare will begin covering anti-obesity medications (Wegovy, Mounjaro, etc.) following price negotiations announced in late 2025 Many commercial insurers now cover GLP-1s with prior authorization (typically requiring BMI 30 or 27 with comorbidity) State Medicaid programs are expanding coverage (varies by state, but momentum is building) What prior authorizations typically require: Documentation of BMI and weight history Evidence of lifestyle modification attempts (diet, exercise programs) Absence of contraindications (pregnancy, medullary thyroid cancer history, etc.) Sometimes, participation in a structured weight management program Psychiatrists and PMHNPs should be prepared to: Fill out detailed PA forms Document comprehensive treatment plans (not just patient wants to lose weight) Coordinate with dietitians or health coaches if insurers require multidisciplinary care Billing for Weight Management Visits E/M Codes: Most weight management consultations are billed using standard evaluation and management codes: 99202-99205: New patient visits (initial consult: typically 99203 or 99204, ~$150-200 Medicare reimbursement) 99212-99215: Established patient visits (follow-ups: typically 99213 for 15-20 min med checks, ~$75-120 Medicare) Obesity-Specific Codes: G0447: Face-to-face behavioral counseling for obesity, 15 minutes (Medicare pays ~$25-30) Can be billed in addition to E/M if you provide separate intensive behavioral counseling beyond medication management Psychiatric Codes: If youre combining weight management with psychiatric medication management in the same visit: Use psychiatric evaluation codes (90792 for initial, ~$200) or Time-based E/M codes that include both medical decision-making for psych meds and metabolic management Telehealth Modifiers: Add modifier 95 or GT (depending on payer) to indicate the visit was via telehealth

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Its important to note that while some may experience rapid changes, others may lose weight more gradually