New calendar year?
Obtain a new physician referral for follow-up MNT.
⚡ Path A
I need to order MNT now
Use this sequence before sending the referral.
1
Qualifying diagnosis
Diabetes mellitus or qualifying renal disease. Maintenance-dialysis services are excluded from the separate renal MNT benefit.
2
MD/DO referral
Medicare MNT referral must be made by a physician, defined for this benefit as an MD or DO.
Stop: NP, PA, or CNS cannot independently make the Medicare MNT referral. This differs from DSMT.
3
Qualifying diagnosis stated
Identify diabetes or qualifying renal disease on the referral. Including the current ICD-10-CM code is operationally helpful, although national MNT rules do not expressly make the numeric code a required referral-document field.
4
Physician record supports it
Document the qualifying diagnosis and the physician decision/referral for MNT in the medical record.
Copy chart support
Patient has [diabetes mellitus / qualifying renal disease]. Medical Nutrition Therapy is medically indicated. Referral for Medicare-covered MNT placed today.
5
Authenticated, dated, NPI available
Authenticate and date the documentation/order and provide the correct individual physician NPI to the MNT provider.
Copy referral wording
Refer for Medical Nutrition Therapy for [qualifying diagnosis / ICD-10-CM]. Medicare MNT referral made by MD/DO.
Four special situations
Check before sending
New episode of care?
Obtain a physician referral for each episode of care.
Additional hours?
Obtain a second/additional physician referral before exceeding the standard annual hours.
Why extra hours?
Document a change in diagnosis, medical condition, or treatment regimen related to diabetes or renal disease that requires a change in MNT.
🏛️ Medicare rule or facility request?
Do not confuse the two
🎯 MNT knowledge check
Test the common failure points
⚕️ Scope & use
This guide describes Original Medicare national MNT requirements. Medicare Advantage plans and receiving facilities may have additional administrative processes. No PHI is collected or stored.