Unlike Medicare which is a federal program with standardized and well-defined details on national coverage, Medicaid programs vary state to state. Identify Medicaid coverage for MNT in your state and learn more about the Medicaid and the National Diabetes Prevention Program. Topics covered on this page:
- Identifying Medicaid Coverage for MNT by State
- Medicaid and the National Diabetes Prevention Programs
Identifying Medicaid coverage for MNT by State
Unlike Medicare which is a federal program with standardized and well-defined details on national coverage, Medicaid programs vary state to state. Each state establishes its own Medicaid eligibility standards within a broad set of national guidelines. States also determine the type, amount, duration, and scope of services; set the rate of payment for services; and administer their own program. This makes identifying and providing common language regarding Medicaid MNT coverage difficult at best.
Medicaid coverage for MNT for adults and children varies state to state, plans may change over time, and certain states may not even recognize RDNs as approved Medicaid providers.
Federal law requires states to provide certain "mandatory" benefits and allows states the choice of covering other "optional" benefits. Mandatory benefits include services like inpatient and outpatient hospital services, physician services, laboratory and x-ray services, and home health services, among others. Optional benefits include services like prescription drugs, case management, physical therapy, and occupational therapy. Nutritional coverage details are not outlined specifically by Medicaid in the list of optional benefits, however MNT could fall under "Other diagnostic, screening, preventive and rehabilitative services." See a list of mandatory and optional benefits for Medicaid programs.
Medicaid and the Diabetes Prevention Program
Individual state Medicaid benefits may include coverage for the National Diabetes Prevention Program (National DPP) which focuses on people with prediabetes.
Authorized by Congress and established by the Centers for Disease Control and Prevention (CDC), the National DPP is a community-based partnership of public and private organizations working to prevent or delay type 2 diabetes using evidence-based, affordable, and high-quality lifestyle change programs.
View a NDPP infographic.
The CDC has developed a cooperative agreement with health departments in all 50 states and the District of Columbia to strengthen chronic disease prevention and management efforts through the implementation of evidence-based strategies, including the National DPP.
As of 2018, the National DPP is covered by the following state Medicaid programs:
- MT, MN, and VT are currently covering the program.
- CA and NJ have passed legislation to cover the program and are working on implementation for 2019.
- MD and OR have been participating in a CDC funded demonstration project that ends October 2018.
- AR and PA are conducting pilots with Medicaid Managed Care Organizations in 2018.
To find out more about the CDC recognized lifestyle change programs to prevent or delay type 2 diabetes, visit Research-Based Prevention Program.
Go to Find a Program to search for a local or online CDC-recognized lifestyle change program.
Learn more about requirements for CDC Diabetes Prevention Program Recognition.
The following resources may help you locate information about Medicaid coverage for MNT in your state.
Email your question to the Academy's Nutrition Services Coverage Team at: firstname.lastname@example.org