Providing coverage of medical nutrition therapy services for individuals with eating disorders under the Medicare program

Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended— (1) in subsection (s)(2)(V)— (A) by redesignating clauses (i) through (iii) as subclauses (I) through (III), respectively, and adjusting the margins accordingly; (B) in subclause (III), as so redesignated, by striking the semicolon at the end and inserting; or; (C) by striking beneficiary with diabetes and inserting the following: beneficiary— (i) with diabetes; and (D) by adding at the end the following new clause: (ii) beginning January 1, 2026, with an eating disorder (as defined by the Secretary in accordance with most recent edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association);; and (2) in subsection (vv)— (A) in paragraph (1)— (i) by inserting (including management of an eating disorder (as defined for purposes of subsection (s)(2)(V)(ii))) after disease management; and (ii) by striking which are furnished by and all that follows through the period and inserting “which are furnished— (A) by a registered dietitian or nutrition professional (as defined in paragraph (2)); (B) pursuant to a referral by— (i) a physician (as defined in subsection (r)(1)); or (ii) a psychologist (or other mental health professional to the extent authorized under State law); and (C) in the case of such services furnished to an individual for the purpose of management of such an eating disorder, at the times specified in paragraph (4).; and (B) by adding at the end the following new paragraph: (4) (A) For purposes of paragraph (1)(C), the times specified in this paragraph are, with respect to medical nutrition therapy services furnished to an individual for purposes of management of an eating disorder, at least the following: (i) 13 hours (including a 1-hour initial assessment and 12 hours of reassessment and intervention) during the 1-year period beginning on the date such individual is first furnished such services. (ii) Subject to subparagraph (B), 4 hours during each subsequent 1-year period. (B) The Secretary may apply such other reasonable limitations with respect to the furnishing of medical nutrition therapy services for purposes of management of an eating disorder during a period described in subparagraph (A)(ii) as the Secretary determines appropriate..