Does Medicare Pay for Nutritional Counseling?

Eating right goes a long way toward getting and staying healthy, and Medicare beneficiaries with certain health conditions have some coverage options related to dietitians and nutritional therapy. 

Medical nutrition therapy (MNT) services are covered by Medicare Part B and all Medicare Advantage (Medicare Part C) plans for:

• People who have diabetes
• People with kidney disease
• People who have had a kidney transplant in the last 36 months.

In order for Medicare to cover counseling with a registered dietitian or other nutritional counseling, your doctor must decide that it’s medically necessary.

Medicare may also cover other nutritional treatments such as diabetic counseling, obesity screenings, and weight-loss counseling. Learn more about how Medicare nutritional coverage works.

When Does Medicare Cover a Dietitian?

Medicare may cover nutritional counseling to include the following services with a nutritionist or dietitian:

• An initial assessment of your diet and lifestyle
• Individual and/or group nutritional therapy sessions
• Assistance managing lifestyle factors that affect your condition
• Follow-up visits

Nutritional therapy is also covered by Medicare as part of overall dialysis care for beneficiaries receiving dialysis in a dialysis facility. 

For beneficiaries in rural areas, nutritional therapy may be provided and covered by Medicare via telehealth. 

Nutritional therapy must be provided by a Registered Dietician or other nutritional professional who meets certain Medicare requirements. 

Medicare pays for three hours of nutritional therapy during the first year a beneficiary uses these services while having a diagnosis of renal disease or diabetes, and two hours in each subsequent year. If a doctor thinks additional therapy is medically necessary, they may appeal to Medicare for more. 

Many Medicare Advantage (Medicare Part C) plans may cover more dietitian services and nutrition counseling than Original Medicare (Medicare Part A and Part B). Medicare Advantage plans are required to cover everything covered by Original Medicare, and many plans may offer additional benefits not covered by Original Medicare, such as prescription drugs, hearing, dental, vision, meal delivery and more. Some of these additional benefits may include nutritionist services.

Which Parts of Medicare Cover Nutritionist Services?

Nutritional therapy is covered by Medicare Part B, which typically requires a $203 annual deductible (in 2021) followed by 20% coinsurance costs for the remaining balance of covered care. However, because of a stipulation in the Affordable Care Act, the Part B deductible and coinsurance do not apply to nutritional therapy and you will pay nothing for the service when performed by a Registered Dietitian (sometimes spelled “dietician”). When performed by a nurse practitioner or other professional, a copayment or coinsurance may apply. 

Medicare Advantage plans are required by law to provide nutritional therapy free of charge when performed by an in-network provider. Medicare Advantage plans also offer at least the same benefits as Original Medicare (Part A and Part B), which means that Medicare Advantage plans cover a dietician in the same way Medicare Part A and Part B would.

Some Medicare Advantage plans also cover other nutritional benefits such as home meal deliveries and healthy food options for plan members.  

Does Medicare Cover Diabetic Counseling?

Medicare Part B and Medicare Advantage plans also cover some other benefits related to diet and nutrition. 

• Diabetic counseling
  Medicare covers diabetes self-management training (DMST), which teaches you how to cope with and manage your diabetes. The program typically includes tips for healthier eating, being active, monitoring blood sugar, taking medicine and reducing risks. Medicare can cover up to 10 hours of your initial DMST sessions, which includes 1 hour of individual training and 9 hours of group sessions.
  
  
• Obesity screenings and weight-loss therapy
  Medicare Part B and Medicare Advantage plans also provide coverage for obesity behavioral therapy, which involves a dietary assessment and counseling to help you lose weight through diet and exercise. Medicare will initial cover an obesity screening and additional weight-loss counseling if you have a body mass index (BMI) of 30 or higher.
  
  
• Bariatric surgery
  Medicare covers bariatric surgery such as gastric bypass and laparoscopic banding surgery (“lap band surgery”) if you meet certain medical conditions related to morbid obesity.

Be sure to talk to your doctor before you receive any services with a dietician, nutritional therapy or bariatric surgery to make sure Medicare will cover your services and to find out how much they will cost. If you have a Medicare Advantage plan, you can talk to your plan carrier directly to learn more.