BlueCross BlueShield of Tennessee Administrative Services

Preventive Services: Extension of Moderate and Intensive Multicomponent Intervention Visits for Obesity

DESCRIPTION

The purpose of this document is to establish criteria for determining when moderate and intensive, multicomponent intervention visits should be extended beyond the standard limit of 12 visits per annual benefit period.  Examples of moderate and intensive multicomponent interventions include, but are not limited to, diet and nutrition counseling, management activities such as setting weight-loss goals, increasing physical activity, addressing barriers to change, self-monitoring, and lifestyle counseling. 

The U. S. Preventive Services Task Force (USPSTF) found adequate evidence that multicomponent, moderate- to high-intensity interventions for obese children and adolescents age 6 years and older can effectively yield short-term (up to 12 months) improvements in weight status. The USPSTF also found adequate evidence that intensive, multicomponent interventions for obese adults can lead to an average weight loss of 4 to 7 kg (8.8 to 15.4 lbs.) in the first year. These interventions can also improve glucose tolerance and other physiologic risk factors for cardiovascular disease and improve long-term health. 

POLICY

SOURCES

U. S. Preventive Services Task Force. (2012). Screening for and management of obesity in adults: U.S. preventive services task force recommendation statement. Annals of Internal Medicine, 157 (5), 373-378.  

U. S. Preventive Services Task Force. (2010). Screening for obesity in children and adolescents: U. S. preventive services task force recommendation statement. Pediatrics, 125 (2), 361-367.

United States Department of Labor.  Employee Benefits Security Administration. FAQS about affordable care act implementation (Part XXIX) and mental health parity implementation. (October 23, 2015). Retrieved May 18, 2016 from https://www.dol.gov/ebsa/faqs/faq-aca29.html.

ORIGINAL EFFECTIVE DATE:  6/15/2016

MOST RECENT REVIEW DATE:  6/15/2016

ID_Product Development

Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.

This document has been classified as public information.