Telehealth Nutrition Services
Best Practices
The Academy's Best Practices for Registered Dietitians Working with Telehealth Nutrition Companies to Provide Nutrition Services addresses licensure compliance, telehealth laws, contracting practices, billing and professional responsibility.
This resource is provided for educational and informational purposes only and is not a substitute for professional judgment or legal advice. RDs should consult qualified legal counsel when evaluating contracts, compliance obligations or state-specific requirements.
References
Determining if Telehealth is an Appropriate Modality
The use of telehealth should be determined on a case-by-case basis, whether it is clinically appropriate and can meet the same standard as an in-person visit. RDs should consider the patient's clinical needs, acuity, technological access, privacy, payer requirements and whether an in-person assessment or higher level of care is needed to ensure safe, effective and compliant care.
Before entering into an agreement with a telehealth nutrition company, RDs should carefully review how the contract addresses:
- Employment status
- Compensation
- Malpractice coverage
- Liability
- Access to patient records
- Restrictive covenants
- Compliance with licensure, telehealth, privacy and payer requirements
A strong contract should protect the RD's professional independence, clearly define each party’s obligations and ensure the RD is not asked to provide services outside applicable legal, ethical or professional standards.
Before providing telehealth nutrition services, RDs should confirm when they are credentialed and effective with each payer, understand how their National Provider Identifier (NPI), also known as Type 1 NPI, will be used and maintain control over the accuracy of their Council for Affordable Quality Healthcare (CAQH) profile.
Even when a telehealth company manages credentialing, the RD's professional identity and accountability remain tied to the claims submitted under their name and NPI.
Telehealth services must be coded and billed based on the services provided, the time documented, payer-specific rules and medical necessity. RDs remain responsible for ensuring documentation supports the claim, including diagnosis codes, referrals when required, appointment cadence and the clinical rationale for continued care.
The Code of Ethics applies to telehealth practice just as it does to in-person care. RDs should:
- Practice within their education, training and competence
- Maintain required state licensure or authorization
- Use professional judgment to determine whether telehealth is appropriate
- Protect patient confidentiality
- Ensure documentation, coding, billing and use of their NPI accurately reflect the services provided
RDs should carefully review telehealth regulations in every state they provide services. Refer to the Academy's Telehealth Laws Impacting State Dietetics/Nutrition Authorization Requirements document for additional guidance.
Telehealth Nutrition Service Resources
References
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