Re: Medicare to pay for obesity counseling sessions - but NOT with dietitians

[Guest guest]

Hi Shelby,

To answer your question, yes a physician can charge for reimbursement from CMS

when furnished by auxilliary personnel (e.g. RD's) and billed as " incident to "

services in accordance with CMS policy. The physician must be physically

present in the office suite or clinic or be available to provide assistance and

direction throughout the time the service is being provided.

Auxilliary personnel means any individual who is acting under the supervision of

a physician, regardless if the individual is an employee, leased employee or

independent contractor of the physician. I got this information directly from a

memo ADA's Coding and Coverage Committee released just yesterday responding to

this new ruling.

This means that RD's can negotiate a rate with physicians to provide a service

but cannot bill Medicare directly for the visit. The physician would bill and

then pay the RD directly. Many RD's already have this type of arrangement with

physicians and this is currently being done for other disease states. Now

obesity is a covered benefit which it never was prior to CMS ruling. Hope this

answers your question.

Kathleen Wall, RD, CDE

former CDA Healthcare Reimbursement Representative.

>

>

http://www.news-medical.net/news/20111130/Medicare-to-pay-for-obesity-counseling\

-sessions.aspx

>

> " Screening for obesity and counseling for eligible beneficiaries by primary

> care providers are covered under the new benefit, CMS added. For those

> patients who are diagnosed to be obese based on body mass index measures,

> the benefit would include one face-to-face counseling visit each week for

> one month and one face-to-face counseling visit every other week for an

> additional five months. Medicare patients who lose at least 6.6 pounds (3

> kilograms) during the first six months of counseling would be eligible to

> receive addition face-to-face counseling once a month for an additional six

> months for up to a total of 12 months of counseling, the agency said.

>

> O'Neil, president of the Obesity Society, a group of weight-control

> researchers and professionals, said the change recognizes the medical

> significance of obesity. *However, it doesn't cover treatment provided by

> dietitians and psychologists. "

>

> *A colleague of mine (not a RD or physician) argued that the physician

> could take the reimbursement money and then use it to pay the dietitian to

> do the counseling (ideally).

>

> Is that even possible? Can a doctor charge for reimbursement when they

> themselves don't perform the service?

>

> Shelby , MS, RD, LD

>

>

>

[Guest guest]

Good to know Kathleen! So does this mean that the PCP would bill the G code for

nutrition counseling under their own NPI? I thought that code was billable

for RDs? I do not think we would be allowed to bill just an office visit code

like 99214. I am an RD in a PCP office and I always bill medicare with my own

NPI etc but other insurances if I am not a provider and they allow me to bill

under the docs NPI I do with the G code for MNT. I am very cautious with

Medicare as I hear of PCP/Docs getting audited all the time and they check the

records and billing! Thanks

Loew, MS, MA, RD, LD

23 Stiles Rd Suite 213

Salem, NH 03079

P: ext 2

F:

jeloew@...

Subject: Re: Medicare to pay for obesity counseling sessions - but NOT

with dietitians

To: rd-usa

Date: Thursday, December 1, 2011, 5:31 PM

 

Hi Shelby,

To answer your question, yes a physician can charge for reimbursement from CMS

when furnished by auxilliary personnel (e.g. RD's) and billed as " incident to "

services in accordance with CMS policy. The physician must be physically present

in the office suite or clinic or be available to provide assistance and

direction throughout the time the service is being provided.

Auxilliary personnel means any individual who is acting under the supervision of

a physician, regardless if the individual is an employee, leased employee or

independent contractor of the physician. I got this information directly from a

memo ADA's Coding and Coverage Committee released just yesterday responding to

this new ruling.

This means that RD's can negotiate a rate with physicians to provide a service

but cannot bill Medicare directly for the visit. The physician would bill and

then pay the RD directly. Many RD's already have this type of arrangement with

physicians and this is currently being done for other disease states. Now

obesity is a covered benefit which it never was prior to CMS ruling. Hope this

answers your question.

Kathleen Wall, RD, CDE

former CDA Healthcare Reimbursement Representative.

>

>

http://www.news-medical.net/news/20111130/Medicare-to-pay-for-obesity-counseling\

-sessions.aspx

>

> " Screening for obesity and counseling for eligible beneficiaries by primary

> care providers are covered under the new benefit, CMS added. For those

> patients who are diagnosed to be obese based on body mass index measures,

> the benefit would include one face-to-face counseling visit each week for

> one month and one face-to-face counseling visit every other week for an

> additional five months. Medicare patients who lose at least 6.6 pounds (3

> kilograms) during the first six months of counseling would be eligible to

> receive addition face-to-face counseling once a month for an additional six

> months for up to a total of 12 months of counseling, the agency said.

>

> O'Neil, president of the Obesity Society, a group of weight-control

> researchers and professionals, said the change recognizes the medical

> significance of obesity. *However, it doesn't cover treatment provided by

> dietitians and psychologists. "

>

> *A colleague of mine (not a RD or physician) argued that the physician

> could take the reimbursement money and then use it to pay the dietitian to

> do the counseling (ideally).

>

> Is that even possible? Can a doctor charge for reimbursement when they

> themselves don't perform the service?

>

> Shelby , MS, RD, LD

>

>

>

[Guest guest]

Hi ,

I'm curious that you use G codes for billing nutrition counseling. The only 2 G

codes I know Medicare accepts are G0271, G0272. Typically MNT is billed uner

97802 and 97803. I don;t know tha exact CPT code that the PCP will use but

there are education and training codes I assume they are using. The visit would

be billed under his NPI because payment goes to the PCP not the RD directly so

your NPI would be necessary.

Kathleen

> >

> >

http://www.news-medical.net/news/20111130/Medicare-to-pay-for-obesity-counseling\

-sessions.aspx

> >

> > " Screening for obesity and counseling for eligible beneficiaries by primary

> > care providers are covered under the new benefit, CMS added. For those

> > patients who are diagnosed to be obese based on body mass index measures,

> > the benefit would include one face-to-face counseling visit each week for

> > one month and one face-to-face counseling visit every other week for an

> > additional five months. Medicare patients who lose at least 6.6 pounds (3

> > kilograms) during the first six months of counseling would be eligible to

> > receive addition face-to-face counseling once a month for an additional six

> > months for up to a total of 12 months of counseling, the agency said.

> >

> > O'Neil, president of the Obesity Society, a group of weight-control

> > researchers and professionals, said the change recognizes the medical

> > significance of obesity. *However, it doesn't cover treatment provided by

> > dietitians and psychologists. "

> >

> > *A colleague of mine (not a RD or physician) argued that the physician

> > could take the reimbursement money and then use it to pay the dietitian to

> > do the counseling (ideally).

> >

> > Is that even possible? Can a doctor charge for reimbursement when they

> > themselves don't perform the service?

> >

> > Shelby , MS, RD, LD

> >

> >

> >

[Guest guest]

Please explain to me how this happened to us.  With all the money we have

invested in our professional organization and it's ADPAC, Medicare is telling

the public that nurses (and  doctors) are more qualified to do nutritional

counseling than dietitians.  I guess all our academic qualifications are a

waste. 

 

Hill, MS,RD,LD/N,CLT

Subject: Re: Medicare to pay for obesity counseling sessions - but NOT

with dietitians

To: rd-usa

Date: Friday, December 2, 2011, 2:51 PM

 

Hi ,

I'm curious that you use G codes for billing nutrition counseling. The only 2 G

codes I know Medicare accepts are G0271, G0272. Typically MNT is billed uner

97802 and 97803. I don;t know tha exact CPT code that the PCP will use but there

are education and training codes I assume they are using. The visit would be

billed under his NPI because payment goes to the PCP not the RD directly so your

NPI would be necessary.

Kathleen

> >

> >

http://www.news-medical.net/news/20111130/Medicare-to-pay-for-obesity-counseling\

-sessions.aspx

> >

> > " Screening for obesity and counseling for eligible beneficiaries by primary

> > care providers are covered under the new benefit, CMS added. For those

> > patients who are diagnosed to be obese based on body mass index measures,

> > the benefit would include one face-to-face counseling visit each week for

> > one month and one face-to-face counseling visit every other week for an

> > additional five months. Medicare patients who lose at least 6.6 pounds (3

> > kilograms) during the first six months of counseling would be eligible to

> > receive addition face-to-face counseling once a month for an additional six

> > months for up to a total of 12 months of counseling, the agency said.

> >

> > O'Neil, president of the Obesity Society, a group of weight-control

> > researchers and professionals, said the change recognizes the medical

> > significance of obesity. *However, it doesn't cover treatment provided by

> > dietitians and psychologists. "

> >

> > *A colleague of mine (not a RD or physician) argued that the physician

> > could take the reimbursement money and then use it to pay the dietitian to

> > do the counseling (ideally).

> >

> > Is that even possible? Can a doctor charge for reimbursement when they

> > themselves don't perform the service?

> >

> > Shelby , MS, RD, LD

> >

> >

> >

[Guest guest]

that's what I'm thinking as well. But we have an Academy! yes, a bit of sarcasm.

Raphaela Rozanski, MS, RD, CLT

> > >

> > >

http://www.news-medical.net/news/20111130/Medicare-to-pay-for-obesity-counseling\

-sessions.aspx

> > >

> > > " Screening for obesity and counseling for eligible beneficiaries by

primary

> > > care providers are covered under the new benefit, CMS added. For those

> > > patients who are diagnosed to be obese based on body mass index measures,

> > > the benefit would include one face-to-face counseling visit each week for

> > > one month and one face-to-face counseling visit every other week for an

> > > additional five months. Medicare patients who lose at least 6.6 pounds (3

> > > kilograms) during the first six months of counseling would be eligible to

> > > receive addition face-to-face counseling once a month for an additional

six

> > > months for up to a total of 12 months of counseling, the agency said.

> > >

> > > O'Neil, president of the Obesity Society, a group of

weight-control

> > > researchers and professionals, said the change recognizes the medical

> > > significance of obesity. *However, it doesn't cover treatment provided by

> > > dietitians and psychologists. "

> > >

> > > *A colleague of mine (not a RD or physician) argued that the physician

> > > could take the reimbursement money and then use it to pay the dietitian to

> > > do the counseling (ideally).

> > >

> > > Is that even possible? Can a doctor charge for reimbursement when they

> > > themselves don't perform the service?

> > >

> > > Shelby , MS, RD, LD

> > >

> > >

> > >

[Guest guest]

Maybe ADA (alias academy) should be worried about something rather than a d---

name change.

Subject: Re: Medicare to pay for obesity counseling sessions - but NOT

with dietitians

To: rd-usa

Date: Saturday, December 3, 2011, 12:41 PM

 

that's what I'm thinking as well. But we have an Academy! yes, a bit of sarcasm.

Raphaela Rozanski, MS, RD, CLT

> > >

> > >

http://www.news-medical.net/news/20111130/Medicare-to-pay-for-obesity-counseling\

-sessions.aspx

> > >

> > > " Screening for obesity and counseling for eligible beneficiaries by

primary

> > > care providers are covered under the new benefit, CMS added. For those

> > > patients who are diagnosed to be obese based on body mass index measures,

> > > the benefit would include one face-to-face counseling visit each week for

> > > one month and one face-to-face counseling visit every other week for an

> > > additional five months. Medicare patients who lose at least 6.6 pounds (3

> > > kilograms) during the first six months of counseling would be eligible to

> > > receive addition face-to-face counseling once a month for an additional

six

> > > months for up to a total of 12 months of counseling, the agency said.

> > >

> > > O'Neil, president of the Obesity Society, a group of

weight-control

> > > researchers and professionals, said the change recognizes the medical

> > > significance of obesity. *However, it doesn't cover treatment provided by

> > > dietitians and psychologists. "

> > >

> > > *A colleague of mine (not a RD or physician) argued that the physician

> > > could take the reimbursement money and then use it to pay the dietitian to

> > > do the counseling (ideally).

> > >

> > > Is that even possible? Can a doctor charge for reimbursement when they

> > > themselves don't perform the service?

> > >

> > > Shelby , MS, RD, LD

> > >

> > >

> > >

[Guest guest]

That's the thing with ADA. they tell us they are doing " so much for our

profession " in DC and then comes something like that. And then they wonder, up

in Chicago, why we don't trust them or believe them when they say they work hard

for our profession recognition, and why I didn't run to donate $$$ to ADAPAC

when they last asked for it.

Give me a GOOD reason, show me results (and please don't tell me 'MNT

reimbursmnet', because I am rethinking the concept of " something is better then

nothing " ) and I will find the $$ to donate.

Merav Levi, RD, MS, CDN, CSG

A dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin

" People don't forget the truth, they just become better in lying " (Revolutionary

Road)

To: rd-usa

From: gailbeckrd@...

Date: Sat, 3 Dec 2011 15:44:08 -0800

Subject: Re: Re: Medicare to pay for obesity counseling sessions - but

NOT with dietitians

Maybe ADA (alias academy) should be worried about something rather than a d---

name change.

Subject: Re: Medicare to pay for obesity counseling sessions - but NOT

with dietitians

To: rd-usa

Date: Saturday, December 3, 2011, 12:41 PM

that's what I'm thinking as well. But we have an Academy! yes, a bit of sarcasm.

Raphaela Rozanski, MS, RD, CLT

> > >

> > >

http://www.news-medical.net/news/20111130/Medicare-to-pay-for-obesity-counseling\

-sessions.aspx

> > >

> > > " Screening for obesity and counseling for eligible beneficiaries by

primary

> > > care providers are covered under the new benefit, CMS added. For those

> > > patients who are diagnosed to be obese based on body mass index measures,

> > > the benefit would include one face-to-face counseling visit each week for

> > > one month and one face-to-face counseling visit every other week for an

> > > additional five months. Medicare patients who lose at least 6.6 pounds (3

> > > kilograms) during the first six months of counseling would be eligible to

> > > receive addition face-to-face counseling once a month for an additional

six

> > > months for up to a total of 12 months of counseling, the agency said.

> > >

> > > O'Neil, president of the Obesity Society, a group of

weight-control

> > > researchers and professionals, said the change recognizes the medical

> > > significance of obesity. *However, it doesn't cover treatment provided by

> > > dietitians and psychologists. "

> > >

> > > *A colleague of mine (not a RD or physician) argued that the physician

> > > could take the reimbursement money and then use it to pay the dietitian to

> > > do the counseling (ideally).

> > >

> > > Is that even possible? Can a doctor charge for reimbursement when they

> > > themselves don't perform the service?

> > >

> > > Shelby , MS, RD, LD

> > >

> > >

> > >