Part B Medicare Benefits for Medical Nutrition Therapy

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Glossary of Terms
Quick Guide
FAQs
Selected Resources
DSMT/MNT FAQs
Enhancing Your Benefit

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Selected Resources on MNT, DSMT, and Reimbursement

1. American Association of Diabetes Educators. AADE Reimbursement Primer. A comprehensive resource which covers information about the health care system and reimbursement for diabetes education. 2000. Available from AADE 800-338-3633 or www.aadenet.org. Price: $20 member; $40 non-member. (A 2nd edition of this manual is in development. It is estimated to be completed in Fall 2002.)

2. American Diabetes Association. Education Recognition Programs (ERP). Phone: 888-232-0822; Web site: www.diabetes.org/recognition. You'll find a listing of ERPs in each state, information about ERPs and the application process.

3. American Dietetic Association. American Dietetic Association Medical Nutrition Therapy Evidence Based Guides for Practice. The protocols are available for purchase from American Dietetic Association as CD-Roms are: Diabetes Type 1 and Type 2, and Gestational Diabetes.

4.  Practitioners can purchase available CD-Roms by calling American Dietetic Association's Member Service Center at 800-877-1600 ext. 5000 or visiting American Dietetic Association's online catalog at www.eatright.com/catalog/. American Dietetic Association's member price: $15.00 and non-member price: $25.00.

For more information and/or to purchase, visit American Dietetic Association web site www.eatright.org/qm or send an email to mntguides@eatright.org. 

5. American Dietetic Association. Medical Nutrition Therapy Works. 2001. A kit consisting of reproducible masters to be used in promoting MNT services. Available from American Dietetic Association. Free to members. Contact ADA's Health Care Financing team for details, reimburse@eatright.org. 

6. American Dietetic Association Medicare MNT Benefit Provider Information. This Guide is a resource to help you understand the Medicare maze and learn how to comply with regulations for the new Medicare MNT benefit for diabetes and non-dialysis kidney disease. This guide can help you understand benefit regulations, program compliance, provider enrollment and claims processing. Included are the Centers for Medicare & Medicaid (CMS) Provider applications forms, Medicare MNT benefit 2002 payment schedule, and instructions for completing the HCFA 1500 billing form, frequently asked questions, a glossary of Medicare terms, plus additional official government documents. Cost to American Dietetic Association members is $30.00 and $35.00 for non-members. Contact the American Dietetic Association's Member Service Center at 800/877-1600 ext. 5000 and ask for item number 4033.

7. American Dietetic Association. Medicare MNT Provider - a newsletter from American Dietetic Association. This newsletter includes continuous updates of the Medicare program and its requirements, guidelines for practice, billing, compliance, etc. For more information call American Dietetic Association's Member Services Call Center 800-877-1600 ext. 5000 to subscribe over the phone or access information about the newsletter at www.eatright.com/mntletter.html. 

8. CMS Program Memorandum, MNT Services for Beneficiaries with Diabetes or Renal Disease. Published August 7, 2001. To review this document go to: www.cms.hhs.gov/manuals/pm_trans/B0148.pdf. Then go to Program Transmittals and look for: B-01-48.

9. CMS Program Memorandum, Additional Clarification for MNT Services (includes instructions for carriers based on NCD. Published May 1, 2002. To review this document go to: www.cms.hhs.gov/manuals/pm_trans/AB02059.pdf. Then go to Program Transmittals and look for: AB-02-059.

10. Daly A, Leontos C: Legislation for Health Care Coverage for Diabetes Self-Management Training, Equipment, and Supplies: Past, Present, and Future. Diabetes Spectrum. 12(4) 222-230, 1999.

11. Expanded Coverage of Diabetes Out-Patient Self-Management Training, June 15, 2001. PM B-01-40. To review this document go to: www.cms.hhs.gov/manuals/pm_trans/B0140.pdf. Then go to Program Transmittals and look for: B-01-40.

12. Final MNT Regulations. CMS-1169-FC. Federal Register, November 1, 2001. Department of Health and Human Services. 42 CFR Parts: 405, 410, 411, 414, and 415. Or read document on American Dietetic Association web site: http://www.eatright.org/cmsfinal110101.html. 

13. Franz M, Reader D, Monk A: Implementing Group and Individual Medical Nutrition Therapy for Diabetes. American Diabetes Association, 2002

14. Medicare Program; Expanded Coverage for Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements; Final Rule and Notice. Federal Register, December 29, 2000, 42 CFR, Parts 410, 414, 424, 480 and 498, Vol. 65, No 251, p 83129-83154.

15. Medicare Coverage Policy Decision: Duration and Frequency of the Medical Nutrition Therapy (MNT) Benefit (#CAG-00097N). Review this on CMS's web site http://www.cms.hhs.gov/coverage/8b3-ggg.asp. 

16. Mensing C, et al.: National Standards for Diabetes Self-Management Education, Diabetes Care. 25(Supp 1): S140-S147, 2002.

17. Pastors JG, Warshaw H, Daly A, Franz M, Kulkarni K: The Evidence for the Effectiveness of Medical Nutrition Therapy in Diabetes Management. Diabetes Care. 25(3):608-613, 2002.

18. Resources on state laws (mandates) passed in 46 states which improve coverage for diabetes education, including nutrition counseling; and diabetes supplies:

- Diabetes State Law Manual. American Diabetes Association, 2000.

- www.aadenet.org/gov_frame.html, go to Insurance Reimbursement by State, Directory of Coverage (pdf file) (on American Association of Diabetes Educators' web site

- Daly A, Leontos C: Legislation for Health Care Coverage for Diabetes Self-Management Training, Equipment, and Supplies: Past, Present, and Future. Diabetes Spectrum. 12(4) 222-230, 1999.

19. Web sites:

- American Dietetic Association: www.eatright.org/gov. To access some of the information on this site, such as Systems Evaluati Association membership number.

- American Diabetes Association: www.diabetes.org 

- American Association of Diabetes Educators: www.aadenet.org 

- Centers for Medicare and Medicaid Services (formerly HCFA): www.cms.gov 

- To read online CMS Program Memorandum/Tranmittals (these are the communications from CMS to their fiscal intermediaries and carriers): go to: www.hcfa.gov/pubforms/transmit/memos. Then go to Transmittals or Program Memos and look for the number of the communication you want.

- To find the Medicare Fiscal Intermediary, Carrier or Durable Medical Equipment Regional Carrier (DMERC) in your state go to: http://cms.hhs.gov/contacts/incardir.asp. Check the Medicare carriers' web pages for newsletters, training information and other resources. Access the carrier address information from CMS' web page.