Chapter 4. Medical Nutrition Therapy Benefit
The Medical Nutrition Therapy (MNT) benefit is a complementary service to DSMT that registered dietitians or nutrition professionals can provide to persons with diabetes. This Medicare Part B benefit covers comprehensive nutrition therapy to foster behavior change. MNT provides 3 hours of individualized care during the first 12 month period following initiation of services.
After a Medicare beneficiary receives the initial 3 hours of MNT in the first 12-month period, the beneficiary is eligible for additional follow-up training in subsequent years. The subsequent training benefit equates to two (2) hours per year as long as the beneficiary continues to have a diagnosis of diabetes. MNT can be provided individually or in a group setting and requires a written provider (e.g., physician or nurse practitioner) referral prior to the initiation of therapy.
If one of the following medical conditions exists, a medical provider can order additional MNT beyond the initial three (3) hour benefit. However, the additional hours must be first approved by the Medicare fiscal intermediary and will require clinical documentation to justify the need for additional services. If approved, the beneficiary will receive up to three hours of additional benefit. Some of the reasons that additional education can be authorized include the following items:
- Change in diagnosis,
- Change in medical condition, or
- Change in the treatment regimen
MNT and DSMT—Together
Like, DSMT, MNT also requires a formal referral, although unlike with DSMT, MNT can be provided to some persons that do not have diabetes. MNT can serve two groups of patients, 1) persons with a diagnosis of diabetes and 2) persons with chronic kidney disease. However, MNT can only be ordered by the treating physician. Non-physician providers are not eligible to write a referral for MNT services. This differs from DSMT in that MNT focuses on the nutritional component of diabetes management. It requires a nutritional intake assessment and then education tailored to the nutritional education deficits that are present.
DSMT and MNT can be provided to the same beneficiary during the same 12 month period. However, they both cannot be provided to the same beneficiary on the same date of service.
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