§ 410.72 Registered dietitians' and nutrition professionals' services.

(a) Definition: Registered dietitians and nutrition professionals. Meet the qualifications at § 410.134. (b) Covered registered dietitian and nutrition professional services. Medicare Part B covers: (1) Coverage condition. Medical nutrition therapy (MNT) services as defined at § 410.130 under the conditions of coverage at § 410.132. (2) Other services. Registered dietitians and nutrition professionals may also provide diabetes self-management (DSMT) services if they are or represent an accredited DSMT entity and have an order from a physician or qualified nonphysician practitioner who is treating the patient's diabetic condition. (3) Limits on MNT and DSMT. (i) DSMT and MNT cannot be furnished to a patient on the same date of service, and (ii) MNT and DSMT services cannot be furnished incident to the professional services of a physician or nonphysician practitioner service. (c) Limitations. The following services are not registered dietitian or nutrition professional services for purposes of billing Medicare Part B: (1) Services furnished by a registered dietitian or nutrition professional to an inpatient of a Medicare-participating hospital. (2) Services furnished by a registered dietitian or nutrition professional to an inpatient of a Medicare-participating SNF. (3) Services furnished by a registered dietitian or nutrition professional to a patient in a Medicare-participating ESRD facility in accordance with the limitation on coverage of MNT service listed at § 410.132(b)(1). (d) Professional services. Except for DSMT services furnished as, or on behalf of, an accredited DSMT entity, registered dietitians and nutrition professionals can be paid for their professional MNT services only when the services have been directly performed by them. (e) Telehealth services. MNT and DSMT services may be provided as telehealth services (meeting the requirements in § 410.78) when registered dietitians or nutrition professionals act as distant site practitioners. (f) Restrictions. The services of a registered dietitian or nutrition professional are provided on an assignment-related basis, and a registered dietitian or nutrition professional may not charge a beneficiary in excess of the amounts permitted under 42 CFR 424.55. If a beneficiary has made payment for a service in excess of these limits, the registered dietitian or nutrition professional must refund the full amount of the impermissible charge to the beneficiary.