Medicare coverage of medical nutrition therapy

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Medical nutritional therapy, which may include dietary counseling, is designed to help you learn to eat right so you can better manage your illness. With a doctor or other health care provider’s referral, Medicare will cover 100% of the Medicare approved amount for medical nutrition therapy. The deductible will also not apply. You will pay no copay or deductible for these tests if you see doctors who take assignment. Doctors who take assignment cannot charge you more than the Medicare approved amount.

Medical nutrition therapy covered by Medicare for people:

  • With diabetes
  • With chronic renal disease
  • Who have had a kidney transplant in the past three years

Original Medicare covers medical nutrition therapy for those who qualify with no coinsurance or deductible if you see doctors or other health care providers who accept the Medicare approved amount in full.  Medicare Advantage (MA) plans will cover all preventive services the same as Original Medicare. This means MA plans will not be allowed to charge cost-sharing fees (coinsurances, copays or deductibles) for preventive services that Original Medicare does not charge for as long as you see in-network providers. If you see providers that are not in your plan’s network, charges will typically apply.

Original Medicare will generally cover three hours of medical nutritional therapy for the first year and two hours every year thereafter, although it will cover more hours if your doctor says you need them. In order to have Medicare cover them, you must get these services from a registered dietitian or other qualified nutrition professional. Talk to your doctor if you think you qualify for this benefit.

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LINKS -- Search for Participating Physicians

National Organization of Rare Disorders, Inc. (NORD)

American Diabetes Association

American Kidney Fund

National Forum of End-Stage Renal Disease (ESRD) Networks

National Institute of Diabetes and Kidney Diseases (NIDDK)

National Directory of Medicare Regional Carriers and Intermediaries National A/B MAC Information

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