CMS to cover obesity behavior therapy
Medicare would cover weekly personal visits for the first month; visits every two weeks for the following five months; and then monthly in-person visits the second half of the 12-month period. A participant must lose at least 3 kg (6.61 pounds) in the first six months in order to continue.
Therapy would consist of screening for obesity, a dietary assessment, intensive behavioral counseling and therapy to promote weight loss through diet and exercise.
Obesity is defined as a body mass index (BMI) greater than 30 kg/m2. One third of U.S. adults are obese and at higher risk for cardiovascular diseases, diabetes and cancer.
To qualify for the therapy coverage, obese beneficiaries would have to be competent and meet with a qualified primary care provider, according to an Aug. 31 CMS memo. Nursing facilities would not be reimbursed for such therapy care but would benefit by having a lighter, healthier population to serve.