CMS proposes to cover obesity therapy
Under a proposal issued by the Centers for Medicare & Medicaid Services (CMS), coverage would be extended to include intense behavioral therapy for beneficiaries struggling with obesity.
Obesity is defined as having a body mass index (BMI) of 30 or above. BMI is a measure of body fat based on height and weight. More information and an easy-to-use BMI calculator can be found on the Centers for Disease Control and Prevention website.
Covered therapy would include obesity screening, a nutritional assessment and intensive counseling to promote sustained weight loss through diet and exercise. For counseling furnished by a qualified primary care physician or other approved primary care practitioner in a primary care setting, coverage would be provided for one in-person visit every week for the first month and one in-person visit every other week during months two through six.
Beneficiaries would be assessed at the end of the six-month period. Those who meet certain documented weight loss requirements also would be eligible to receive coverage for one in-person visit each month during months seven through 12.
A final coverage determination is scheduled to be issued in late November and will be posted on the CMS website, according to a CMS spokesman. Once the final decision is posted coverage will begin immediately, he said.
Return to front page