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Medicare and Nutrition Therapy

October 6, 2016

Medical nutrition therapy (MNT) services may be covered by Medicare Part B (medical insurance) if you have diabetes or renal disease. These services may also be covered if you are enrolled in a Medicare Advantage plan  offered by a private insurance company contracted with Medicare because Medicare Advantage plans are required to provide at least the same level of coverage as Original Medicare, Part A (hospital insurance) and Part B (medical insurance), with the exception of hospice care, which continues to be covered by Medicare Part A.

Am I eligible for nutrition therapy?

To be eligible for this type of coverage, you must be enrolled in Medicare and have diabetes or renal disease (kidney disease that does not require dialysis) or have had a kidney transplant in the last 36 months.

Medicare beneficiaries who receive dialysis in a dialysis facility have medical nutrition therapy covered under the umbrella of dialysis care.

What is nutrition therapy?

Medical Nutrition Therapy is a preventive service that may be covered under Medicare Part B. It is provided by a registered dietitian or other qualified health professional. You must have a referral from your doctor to receive the service, which includes:

  • A nutrition and lifestyle assessment, based on information you provide about your eating patterns, activity level, etc.
  • Nutrition counseling and goals, based on the nutrition and lifestyle assessment and on medical information, such as blood pressure or blood glucose numbers, provided by you and your doctor.
  • Information regarding managing lifestyle factors that affect diet and health.
  • Follow-up visits to monitor your progress.

You pay nothing for these services, provided the health-care professional performing the nutrition therapy accepts Medicare assignment. Treatments vary according individual needs and health condition, but always include a nutritional assessment and  in-person and/or telehealth nutrition counseling. .

The initial assessment is performed so that your doctor has a comprehensive overall idea of your wellness and to determine further treatment, if necessary. From there, your provider may set up counseling sessions that are intended to help you manage diabetes or kidney disease.

How often is nutrition therapy covered under Medicare?

If you have a referral from your doctor, then Medicare will cover medical nutrition therapy every year.  Medicare covers three hours of one-to-one counseling the first year and one hour every year thereafter. Your doctor must prescribe the service and renew the referral every year. If your condition, treatment or diagnosis changes, then you may be able to receive coverage for more hours of treatment

This is only a brief summary, not a complete description of benefits, which may change on January 1 of each year. For more information, contact your Medicare Advantage plan or Medicare Part B administrator. Limitations, copayments, and restrictions may apply to additional related services your physician recommends.