For last week’s practice question, we quizzed participants on medical nutrition therapy coverage. 63% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question
Question: SJ is a 68-year-old recently referred for medical nutrition therapy (MNT). They are on a fixed income and are concerned about their out-of-pocket expense for their upcoming visit. SJ has Medicare (CMS) as their primary insurance.
What can we tell SJ about Medicare’s coverage for MNT services?
Answer Choices:
Answer 1 is incorrect. 5.12% chose this answer. “Medicare provides full coverage and no cost share for all Medical Nutrition Therapy referrals.” While it is true that Medicare provides full coverage and no out-of-pocket cost share, not ALL MNT referrals are covered. Despite continued work towards increasing MNT access, currently, Medicare only provides coverage for specific diagnoses. Referrals must also come from a physician (MD and DO). Medicare does not accept referrals from an NP or PA. Keep reading for more information.
Answer 2 is incorrect. 13.72% of you chose this answer. “Medicare provides 3 hours of MNT services for the initial referral and calendar year and 2 hours after referral in subsequent years.” This answer is true but not the best answer. Medicare will provide coverage of up to 3 hours of MNT services for the first year of referral and 2 hours every calendar year thereafter with physician referral. If a provider determines medical necessity, most often from a change in diagnosis, treatment regimen, or medical condition, a second referral will allow additional hours of MNT services.
Answer 3 is incorrect. About 6.28% of respondents chose this. “Medicare provides coverage for diagnosis of diabetes, non-dialysis CKD stage 3- 5, and post-kidney transplants.” This answer is true but not the best answer. Medicare provides coverage for diabetes diagnoses, non-dialysis CKD stages 3-5, and post-kidney transplants within the last 36 months.
Answer 4 is correct. 62.56% chose this answer. “Both B and C.” Answer D is correct and the best answer.
Finally, Answer 5 is incorrect. 12.33% chose this answer. “All of the Above.” Answer E is incorrect and not the best answer. While advocacy for expansion of MNT services to cover other diagnosis is an active effort, at the time of writing, coverage remains for only the prior mentioned diagnoses.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
Join Coach Beverly and Team for two and a half days of knowledge-sharing, fun, networking, games with prizes, and “aha” moments in beautiful San Diego on October 9-11, 2024.
You don’t want to miss this one-of-a-kind learning opportunity. Get away from all those daily responsibilities and immerse yourself in a fun and intensive conference with plenty of networking opportunities.
Attendees will leave this conference with new tools and a more complete understanding of the latest advances in diabetes care, from medications to technology to Medical Nutrition Therapy!
Each day, we provide a healthy breakfast, including fresh coffee, to kick off your morning. Our instructors co-teach the content to keep things fresh and lively. Plus, we play DiaBingo to reinforce key content and give away prizes. In addition, we provide plenty of movement breaks led by volunteers from the audience. Did we mention delicious lunches and a conference meeting space just minutes from San Diego Bay?
Friend Discount: 3 or more only $559-$799 (based on registration package) per person. Email us at info@diabetesed.net with the name and email of each registrant to get the discount!
Time: The course is Wednesday through Friday. Join us for breakfast at 7:00 a.m. each day. The class begins at 8:00 a.m. and ends at 5:00 p.m. on Wednesday and Thursday and at 3:00 p.m. on Friday.
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.
Diabetes Education Services offers education and training to diabetes educators in the areas of both Type 1 and Type 2 Diabetes for the novice to the established professional. Whether you are training to be a Certified Diabetes Care and Education Specialist (CDCES), practicing at an advanced level and interested in board certification, or a health care professional and/or Certified Diabetes Care and Education Specialist (CDCES) who needs continuing education hours to renew your license or CDCES, we have diabetes education information, resources and training; learning and teaching tools; and diabetes online courses available for continuing education (CE). Read our disclaimer for full disclosure.