Medicare Claims Processing Manual (Pub. 100-04), Ch. 19 § 100.13.2
A/B MAC (A) - MNT - Payment Policy
100.13.2 - A/B MAC (A) - MNT - Payment Policy
(Rev. 1040, Issued: 08-25-06, Effective: 09-11-06, Implementation: 09-11-06)
Section 105 of BIPA permits Medicare coverage of MNT when furnished by a RD
meeting certain requirements. See Chapter 4, §§300 through 300.6 of Pub. 100-04,
Medicare Claims Processing Manual, for more information on these requirements.
If the RD providing the services is either an IHS hospital employee or has contracted
with an IHS hospital to provide MNT services through the hospital outpatient
department, the MNT services are to be provided in the hospital outpatient department or
in a provider-based clinic. Payment is made by the A/B MAC (A) based upon the AIR.
Since hospital outpatient MNT services provided by an RD are provided on hospital
property under the auspices of the hospital, MNT services provided in the home do not fit
the benefit as it is generally rendered when billing to the A/B MAC (A). The RD
employed by an IHS hospital may not be paid for services provided in the beneficiary’s
home.