Reimbursement

MNT and Medicare Reimbursement:

With over 31 million Medicare beneficiaries (28% with diabetes and 17% with CKD), RDNs can make a significant difference in the health of this population. Having a sufficient pool of RDN Medicare providers demonstrates to CMS that there is support to expand coverage to other disease states and support increased coverage by private and public payers.

For more information on Medicare provider enrollment, visit https://www.eatrightpro.org/payment/medicare/medicare-provider-enrollment

Quality Payment Program:

Signed into law in April 2015, the Medicare Access and CHIP Reauthorization Act repealed the Sustainable Growth Rate formula and combined various quality and reporting programs into one program- the Quality Payment Program. Under the QPP, payments for Medicare Part B services are shifted away from fee-for-service to pay-for-performance. This new Medicare payment program is evolving and providers should expect ongoing changes in the QPP in the coming years.

https://www.eatrightpro.org/payment/medicare/quality-payment-program

Coding and Billing:

For information on coding and billing, including diagnosis codes for MNT, CPT and G codes, and coding for malnutrition, visit https://www.eatrightpro.org/payment/coding-and-billing/diagnosis-and-procedure-codes

Join the Online Reimbursement Community:

To connect with other RDNs, share ideas, and receive support, join the online reimbursement community. This service is free to all Academy members. Please note that there is no discussion of fee information.

https://www.eatrightpro.org/payment/getting-started/becoming-a-provider/join-the-reimbursement-online-community

MNT Provider:

Your source for practice management news, the MNT Provider is a monthly newsletter specifically tailored for registered dietitians. Free to Academy members, the MNT Provider includes articles on topics such as billing, coding and coverage, practice and business management, health care reform, Medicare, Medicaid and private insurance reimbursement.

https://www.eatrightpro.org/news-center/in-practice/mnt-provider

Obtaining an NPI number:

The NPI is a unique, 10-digit, identification number for health care providers, practitioners, and suppliers of health care services. The NPI is an important means of demonstrating a viable workforce of qualified providers and practitioners to payors and other external stakeholders.

All credentialed nutrition and dietetics practitioners (RDNs and NDTRs) should have an individual NPI regardless of work environment, employment status, or whether claims are submitted to payers.

The NPI can be used everywhere, so if an individual works at more than one practice location or setting, that individual does not need to get two NPIs. An NPI does not expire or deactivate, unless the individual deactivates it.

Interested in connecting with other RDNs on Reimbursement. Have a question?

Check out our Reimbursement Discussion forum

https://www.eatrightpro.org/payment/getting-started/becoming-a-provider/obtaining-an-npi-or-ein