Does Medicare cover nutrition therapy?

When people think of medical therapy, they seldom consider nutrition. Food is such an integral part of our lives it can seem invisible. And with piles of nutrition information stored on the internet, seeing a food doctor may seem redundant. Dieticians and nutritionists are associated primarily with vegetarians, dieters, athletes and celebrities. But they aren’t just for lifestyle management. They provide “nutrition therapy” for many medical conditions, helping you manage symptoms and get what you need in your diet when eating becomes complicated.

How dieticians and nutritionists can help

If you’ve had a gastric bypass, dieticians and nutritionists can help you get the nutrients you need in small servings. If you’re pregnant or breastfeeding, they can help you take in the nutrients that are essential for the health of your baby. They can help manage the difficulties of diabetes and poor cardiovascular health. And they’re an essential part of the support and treatment of a person suffering from an eating disorder. For select cases, Medicare covers nutrition therapy from these professionals under Medicare Part B.

There are relatively few conditions that will qualify you for covered medical nutrition therapy (MNT) under Medicare. You must first get a referral for the service from your health care provider. The referral must be to a registered dietician or nutritionist. Finally, one of the following things must apply to you to receive coverage:

  • You have diabetes (type 1 or type 2)
  • You have kidney disease not being treated with dialysis
  • You had a kidney transplant within the last 36 months

For people on dialysis, MNT is already covered as part of your dialysis care. Still, these coverage categories are extremely narrow and it may be best for you to seek MNT care even when not covered by Medicare. For instance, if you have prediabetes, using MNT services can help you prevent your condition from developing into diabetes. Though you wouldn’t be covered by Medicare, this can save you from a lot of prolonged health problems.

Nutrition therapy treatment time limits

Even when you qualify for MNT, there are restrictions for how much you can use the service. In your first year of using MNT, you can only get three total hours of MNT services. However, depending on how long your MNT visits are, you can get more visits. If your MNT visits are 15 minutes each, you can get 12 visits in the first year. And you don’t need to see your MNT provider in person for your visits; MNT can be provided over the telephone.

After the first year, the number of hours you can use MNT is reduced to two. However, you can get an exception to the maximum number of treatment hours. If you show symptoms of malnutrition on your current plan when you have kidney disease, or your kidneys become worse, you can get more hours. And if you have diabetes, complications necessitating tighter diet control and a need for frequent diet changes could earn you more treatment hours.

Once you start getting MNT services, Medicare will cover a nutrition and lifestyle assessment, individual or group nutritional counseling, and follow up visits. If you get MNT services from someone who accepts assignment (agrees to be paid by Medicare), Medicare Part B will pay for everything.

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