Who Pays For Nutrition Services?
Medicare and many private insurance companies cover Medical Nutrition Therapy (MNT) for variety of conditions and diseases.
Medicare
Medicare Part B covers MNT services for certain conditions. These services can be given by a Medicare-approved registered dietitian and include a nutritional assessment and counseling.
Patient pays nothing, no copay, no coinsurance and no deductible for the services.
Patient must meet at least one of these conditions:
Have type 1 or type 2 diabetes
Have a chronic kidney disease
Have end stage renal disease (ESRD) and not receiving dialysis
Have a kidney transplant in the last 36 months
A physician referral form is required for a Medicare patient to see a dietitian.
Referral Form Should Include:
Diagnosis code(s)
Most recent labs along with medications
Documentation of medical necessity for MNT in patient’s chart
Affordable Care Act
Affordable Care Act (ACA), requires insurance plans to provide coverage for certain recommended preventive health services related to nutrition counseling.
The patient pays nothing, no copay, no coinsurance and no deductible when delivered by a network provider.
Nutrition counseling under ACA law includes:
Diet counseling for adults aged 18 years or older who are overweight or obese and at risk for hypertension, dyslipidemia, impaired fasting glucose, or metabolic syndrome.
Obesity counseling for adults with body mass index (BMI) 30 kg/m² or higher.
Obesity counseling for children aged 6 years and older with BMIs at ≥85th to 94th percentile.
Diet counseling for people with diabetes.