Telehealth & Reimbursement for MNT
Updated July 31, 2025
Where we stand – 2025-2026 legislative session
MAND hired Bulfinch Strategies Group in November 2022 with the primary goal of establishing permanent payment parity for telehealth MNT.
In the 2023-2024 legislative session, MAND’s lobbyists filed telehealth MNT bills in the House and Senate that were referred to the Joint Committee on Financial Services, then referred to the Joint Committee on Health Care Financing after the Financial Services public hearing was held and MAND provided testimony. Despite this good progress, the bills did not move further in the legislative process, thereby “dying” at the end of the session.
In the 2025-2026 legislative session, MAND’s lobbyists worked to re-file “An Act relative to telehealth parity for nutrition counseling” in the House and Senate. The bills were assigned to Joint Committee on Financial Services and MAND provided verbal testimony in support of the bills at the public hearing held in April 2025.
As of July 31st, the House version of the bill moved forward in the legislative process by being referred to the Joint Committee on Health Care Financing. There is no public hearing scheduled, but MAND and the lobbyists will be sure to provide testimony when needed.
Learn more and read the text of the bill at https://malegislature.gov/Bills/194/H4340
MAND’s Executive Committee and Director of Public Policy continue to work with the lobbyists to follow through on the primary goal of our partnership: advocating for telehealth MNT reimbursement parity until telehealth services provided by RDNs in MA are paid on par with in-person visits.
To learn more about advocating for telehealth MNT, please contact MAND’s Director of Public Policy Sarah Conca, MPA, RDN, LDN at publicpolicy@eatrightma.org.
For questions regarding MAND’s ongoing public policy work and partnership with Bulfinch Strategies, please contact MAND President Robert Dunn, RD, LDN, CNSC. at president@eatrightma.org.
Where we stand - Regulations governing telehealth
In conjunction with our partner organizations in the tMED Coalition, MAND successfully advocated for a number of important changes to the MA Division of Insurance (DOI) telehealth regulations. The changes clarify and expand upon definitions governing telehealth coverage and reimbursement as outlined in the "Patients First Act" (a.k.a., telehealth bill) signed into law on January 1, 2021.
- MAND will continue to advocate for telehealth rate parity until all covered telehealth services provided by dietitians in Massachusetts are paid on par with in-person visits. We will advocate both as the voice of our profession and in coalition with other like-minded organizations. To that end, we continue to advocate for MAND’s MNT telehealth parity bills and the tMED Coalition’s broader telehealth parity bills.
- Until then, we will continue to maximize the application of the existing telehealth rate parity law to our services. With these changes to the DOI regulations, all covered services provided by dietitians via telehealth that fit the broadened definition of “behavioral health services” will be required by law to receive payment on par with an in-person visit.
MAND continues to collaborate with our coalition partners to advocate for the Legislature to extend parity for chronic disease management and primary care, in which case, this broadened definition will decide which services are eligible for telehealth rate parity.
Additional Information - Regulations governing telehealth
Behavioral Health Definition
- The telehealth bill requires insurers to reimburse Behavioral Health Services at parity with in-person services in perpetuity. However, the Legislature tasked DOI with defining in regulation what constitutes BH Services, essentially deciding which BH services are eligible for in-perpetuity telehealth rate parity.
- Along with our coalition partners, MAND was able to successfully advocate for a broad and inclusive definition of BH Services, requiring in-perpetuity telehealth rate parity for “Care and services for the evaluation, diagnosis, treatment, consultation, prescribing, monitoring or management of mental health, developmental, or substance use disorders. Such care and services may be provided by any Health Care Professional for whom such services are within the scope of licensure for such Health Care Professional. Behavioral Health Services shall also include but not be limited to Partial Hospital Programs and Intensive Outpatient Programs.”
Chronic Disease Management Definition
- While the legislative reimbursement parity requirement for chronic disease and primary care services expired on January 1, 2023, we were also able to successfully advocate for a significantly broadened definition of chronic disease management, which now goes well beyond the CMS definition to include congenital anomalies, hereditary conditions and other chronic conditions that last one year or more and require ongoing medical attention or limit activities of daily living or both.
Telehealth in MA – The history
An Act Putting Patients First took effect in January 2021 as part of Chapter 260 of the Acts of 2020. It covered many areas of health care services provision in MA, including “no surprise billing” and COVID-related services.
- It made permanent coverage of and reimbursement parity for behavioral health services provided via all modalities of telehealth, including audio-only.
- It called for coverage of and reimbursement parity for primary care services and chronic disease management through January 2023.
- As of September 2021, for all other services, insurers could reduce reimbursement rates with advance notification.
- Insurers have since announced reimbursement rate cuts for telehealth services.
Telehealth – Learning more
Yes, but there is no guarantee of reimbursement rate parity for nutrition services provided via telehealth. Insurance carriers are acting within the law if they announce rate cuts. "Carriers may choose to continue paying all providers at existing telehealth rates of reimbursement. If Carriers wish to alter telehealth rates of reimbursement where allowed under the law, they are expected, as noted in Bulletin 2021-04, to file implementation plans with the Division that highlight the methods and timing that would apply to all affected providers . . ." (MA Division of Insurance update on telehealth issued September 7, 2021)
Per current MA DOI regulations, credentialed providers need to offer both in-person appointments and telehealth appointments to remain in compliance with many of the insurance providers’ contracts (i.e., should a patient request an in-person visit). Private insurers may have specific requirements related to in person vs remote appointments. You should review the updated telehealth information on insurance companies’ websites for credentialed providers.
Academy members can join the Reimbursement and Payment Online Discussion Community of Interest (COI) to dialogue with other members, learn from colleagues and receive reimbursement updates from Academy staff. In addition to the COI, the Academy convenes the MNT and Payment Advocacy Affinity Group which meets quarterly on Tuesdays from 3:30-4:30 pm ET. This forum-based event brings together staff, policy leaders and members to discuss Academy reimbursement advocacy priorities and strategies, share their experience and determine how they can become involved in advocating. Use this link to join the COI and register for the quarterly affinity group.
