Building Infrastructure for Food as Medicine: The Coding4Food Initiative

The Invisible Problem

Millions of Americans receive medically tailored meals, produce prescriptions, and other food-based healthcare interventions each year. These services can be life-changing, but the healthcare system doesn't actually have a standardized way to bill for, track, or analyze them. Without proper medical codes, providers are literally faxing individual invoices to health plans. It's inefficient, expensive, and makes it nearly impossible to prove these programs work.

A Community-Led Solution

In 2024, I joined Fullwell and the Gravity Project to manage Coding4Food—an effort to secure new medical codes for eight different food-based healthcare interventions. We brought together a national Advisory Committee and nearly 60 technical experts to develop definitions that could be submitted to the Centers for Medicare and Medicaid Services (CMS).

Wearing Multiple Hats

My role meant being both the organizational backbone and bringing nearly two decades of experience in food provision, research, and policy to the table.

On the coordination side, I kept all the pieces moving: running Advisory Committee meetings, launching applications for expert workgroups, managing files, tracking deadlines. The trickiest part was acting as liaison between three groups operating on completely different timelines—the Advisory Committee setting strategy, the expert workgroups doing technical work, and the Gravity Project team handling CMS submissions.

But I wasn't just managing logistics. I sat in on workgroup meetings to help when groups got stuck on tough definitional questions. When people debated whether a "meal" should be defined rigidly or flexibly, or how to make "medically tailored" clinically precise but still operationally realistic, I could draw on years of seeing how these programs actually work in the real world.

What We Accomplished

By December 2024, three workgroups had completed definitions for medically tailored meals, medically tailored groceries, healthy groceries, and produce prescriptions. Gravity submitted these to CMS in January 2025. In February, I supported the launch of a second round of workgroups that developed four more definitions: small kitchen appliances, large kitchen storage appliances, kitchen tools, and cooking education.

All eight applications are now with CMS. But realistically, given everything happening in the federal government right now, approval isn't likely anytime soon. It's frustrating, but the work still matters. Hopefully, these codes will get approved under a future administration.

Why It Matters

If CMS eventually accepts these codes, it'll mean more than just easier billing. It'll create the data infrastructure we need to actually prove that Food as Medicine interventions work across different states and populations. And it'll send a signal that food-based healthcare isn't some experimental side project—it's real healthcare that deserves the same standards as everything else.

It was fun and satisfying to provide the backbone support to keep this complex project moving, while also bringing enough expertise to make sure the final definitions actually make sense in the real world.