Reimbursement
Coding and Billing
Click here for information on coding and billing, including diagnosis codes and coding for malnutrition.
Online Reimbursement Community
To connect with other RDNs and receive support, join the online reimbursement community. This service is free to all Academy members.
NPI Information
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.
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.
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.
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.
Click here for more information on 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Signed into law in April 2015, the Medicare Access and CHIP Reauthorization Act repealed the Sustainable Growth Rate formula and combined various quality and reporting programs into one program called the Quality Payment Program (QPP). 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.