Reimbursement for nutrition ed classes

[Kathrynne Holden, MS,RD]

I received many encouraging responses to my query re insurance
reimbursement for nutritio ed classes, and as requested, will post them
to the list, as follows:

------------
From:  Tom Stone McNees <tstone at stc.net>
The MD will have a physicians' guidebook for billing that lists
allowable codes for each disease or condition.  If it's not listed, it
won't get paid.  That may be what the doctor is referring to.
Tom
------------------

From:  Barbara Gollman <bgollman at airmail.net>
I don't know the answer, but Donna Israel, RD, PhD, has a consulting
group here in Dallas and has done lots with reimbursement.  If you
haven't contacted her, I would think she would be a good resource.  Her
number is 972-690-1117.  Good Luck - and keep us posted!
        Barbara Gollman, MS, RD

-----------------------------------

From:          Laura Walsh <LWALSH at eatright.org>
Medicare has assigned a value of zero to 99078 so they will not
reimburse on that code.  Some insurers may pay on the code but it may
not be on a consistent basis.

Laura Walsh
The American Dietetic Association
800/877-1600 x 4902

------------------

From:          Mindy Nichols <msnichols at bgsm.edu>
Subject:       Re: Reimbursement for nutrition ed classes


I work at a large Family Practice within a Medical School.  We do bill
out
99078.We are reimbursed very little for medical nutrition therapy by
most
insurers.  For instance for a $27.00 bill, $11.49 paid by Medicaid of
NC,
$17.00 MCO: (PHP), $18.90 and 8.40 Aetna, $9.86 Medicare Cigna.  It
continues to be the lowest reimbursement available, for both MCO's and
private insurers.  Some do not pay any.  

I guess you have to go in and sell your product called medical nutrition
therapy and explain the outcomes expected though the MNT.

Mindy Nichols R.D. L.D.N.
email: msnichols at bgsm.edu

-------------------------
From: 
          Vicki Strickland <StricV at mail.health.state.mo.us>
Reply-To: 
          phnutr-l at u.washington.edu
       To: 
          "Public Health Nutrition Discussion and Information Group"
<phnutr-l at u.washington.edu>


Kathrynne,
Have you tried checking with someone at
ADA?  They may be able to help you.

Vicki Strickland
StricV at Mail.Health.State.MO.US
-----------------


Additional suggestion from Susan Conner-Harrington, Riverside County
Dept. of Public Health: "Pages 36-37 of the CPT Code Book. Also utilize
'The Handbook of Medical Nutrition Therapy' and 'Contracting with
Managed Care for Medical Nutrition Therapy' (order through ADA)."


My thanks to all who responded so thoughtfully. I think I have enough
information now to write a proposal to become a health care provider in
this new area.

Best regards to all,
Kathrynne Holden


-- 
Kathrynne Holden, MS, RD
Editor-in-Chief,
"Spotlight on Food--nutrition news for people 60-plus"
http://www.fortnet.org/~fivstar
and NUTRITION TOPICS copy-ready handouts
http://www.dietetics.com/class/fivstar/
Tel: 970-493-6532   Fax: 970-493-6538