Does Medicare Cover Nutrition Counseling?

Nutrition counseling plays a significant role in managing overall health and navigating various medical conditions. This guidance helps individuals understand dietary choices’ impact on their well-being. It provides structured support to develop healthier eating habits and can contribute to the prevention or management of chronic illnesses.

Medicare Part B Coverage for Nutrition Counseling

Medicare primarily covers nutrition counseling through its Part B medical insurance, specifically for certain medical conditions. This coverage is known as Medical Nutrition Therapy (MNT) and is designed for individuals diagnosed with diabetes or kidney disease. MNT services include a comprehensive nutritional assessment, dietary counseling, and follow-up visits to monitor progress and adjust the treatment plan.

For diabetes, MNT covers all types, including Type 1, Type 2, and gestational diabetes. For kidney disease, coverage extends to chronic kidney insufficiency and beneficiaries who have received a kidney transplant within the past 36 months, excluding those receiving dialysis as MNT is bundled into their dialysis care. These services help manage lifestyle factors affecting these conditions.

Medicare Part B also covers Intensive Behavioral Therapy (IBT) for obesity, which focuses on weight loss through diet and exercise. This therapy is available for beneficiaries with a body mass index (BMI) of 30 kg/m² or higher. IBT includes an initial obesity screening, dietary assessment, and behavioral counseling sessions. Original Medicare generally does not cover general wellness or preventative nutrition counseling not directly tied to these specific medical conditions.

Eligibility and Provider Qualifications

To receive covered nutrition counseling services under Medicare, a beneficiary must first obtain a doctor’s referral or order. This referral must confirm a qualifying diagnosis, such as diabetes, kidney disease, or obesity, and affirm that the counseling is medically necessary for the individual’s condition. The treating physician or other qualified healthcare provider must issue this order.

Medical Nutrition Therapy (MNT) must be provided by a Registered Dietitian Nutritionist (RDN) or other nutrition professional who meets specific Medicare enrollment requirements. These professionals have the training and credentials to deliver MNT services. For Intensive Behavioral Therapy (IBT) for obesity, the counseling must be furnished by a primary care physician or another qualified primary care practitioner, such as a nurse practitioner or physician assistant, and delivered in a primary care setting.

Accessing Services and Costs

Beneficiaries seeking covered nutrition counseling should begin by discussing their needs with their primary care physician to obtain the necessary referral. Once a referral is secured, individuals can locate Medicare-enrolled Registered Dietitians or other qualified providers through their doctor’s recommendations or by using Medicare’s online tools. Confirming the provider’s Medicare enrollment helps ensure coverage.

For Medical Nutrition Therapy, Medicare generally covers three hours of services in the first calendar year and two hours in subsequent years. Additional hours may be covered if the treating physician determines a change in the medical condition or treatment regimen necessitates more MNT. Intensive Behavioral Therapy for obesity typically involves one face-to-face visit per week for the first month, followed by one visit every other week for months two through six. If the beneficiary achieves at least a 3 kg (approximately 6.6 pounds) weight loss during the first six months, monthly visits may continue for an additional six months.

Regarding costs, the Medicare Part B deductible applies to Medical Nutrition Therapy services. For 2025, the annual Part B deductible is $257. After the deductible is met, Medicare pays 80% of the Medicare-approved amount, leaving the beneficiary responsible for the remaining 20% coinsurance. Intensive Behavioral Therapy for obesity, when provided by a primary care doctor in a primary care setting, typically has no copayment or coinsurance, and the Part B deductible is waived. Confirm specific costs and coverage limits with the provider and Medicare prior to receiving services.

Medicare Advantage Plans and Supplementary Coverage

Medicare Advantage Plans, also known as Medicare Part C, are offered by private companies approved by Medicare. These plans are required to cover at least the same benefits as Original Medicare (Part A and Part B), which includes covered Medical Nutrition Therapy and Intensive Behavioral Therapy for obesity. Many Medicare Advantage plans may offer additional benefits, such as broader nutrition counseling programs, wellness benefits, or potentially lower cost-sharing for these services. The specific benefits and cost structures can vary significantly among plans. Beneficiaries should review their individual plan documents to understand their exact coverage.

Medicare Supplement Insurance Plans, also known as Medigap policies, can help Original Medicare beneficiaries manage their out-of-pocket costs. These plans work by covering some of the expenses that Original Medicare does not, such as the 20% coinsurance for Medical Nutrition Therapy services after the Part B deductible has been met. Medigap plans do not work with Medicare Advantage plans; they are designed to supplement Original Medicare.