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Its rules align with other PBMs: adults 18 with obesity, BMI 30 (or 27+comorbidity), documented baseline weight and counseling on diet/exercise are required ( [43] )

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If the patient saw a registered dietitian or behavioral health provider for weight-loss counseling, the provider must submit: Visit notes from at least four separate appointments over a 90-day period Documentation of weight at each visit Documentation that weight did not decrease by 5% or more The trap: most primary care providers document "patient reports trying Weight Watchers last year" in their notes

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