This survey was undertaken and is presented here to document the current status of third-party reimbursement for nutrition care services and to emphasize to all ADA members the urgent necessity for education of insurers, physicians, clients, and administrators. Escalating health care costs and the fervor for containment of these costs may at first paint a dismal picture--but it need not. It is a time of uncertainty, reconsideration, and policy evaluation for the insurance industry. Nutrition care services are vital to the health care delivery system, and it is your responsibility to publicize and promote that fact. Each of you must work at the local level with the insurance companies covering your clients, your local Blue Cross/Blue Shield plan, and the commercial carriers operating in your area. You must anticipate some resistance, questions, and possible first-round rejection--but persist and be helpful so that all patients may profit from affordable, reimbursable nutrition care services.