Telehealth & Reimbursement for MNT

Stay informed on telehealth coverage and reimbursement for Medical Nutrition Therapy (MNT). Find guidance and resources to help nutrition professionals navigate billing, coverage, and evolving telehealth policies.

Updated September 2026

Where We Stand:

2025-2026 Legislative Session

MAND has been advocating for permanent telehealth payment parity for MNT for several years, and first introduced its own legislation in the 2024 2025 legislative 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. As of July 31st, 2025, the House version of the bill (H. 4340) was reported favorably and moved forward in the legislative process by being referred to the Joint Committee on Health Care Financing.
Most recently, the active state legislative session ended on July 31st, 2026 and brought with it some good news regarding telehealth payment parity! A primary care spending control bill was passed by both House and Senate and a conference committee of three senators and three representatives was created to work together to reconcile dozens of amendments made to the bill. One key amendment was #96, which would create permanent telehealth payment parity for all primary care and chronic disease management services.
MAND’s Executive Committee and Director of Public Policy will continue advocating for telehealth MNT reimbursement parity until telehealth services provided by RDNs in MA are paid on par with in-person visits. Learn more and read the text of the bill at https://malegislature.gov/Bills/194/H4340
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.

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 -

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

Can nutrition visits still be provided via telehealth?

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)

I am a dietitian in private practice and relinquished my office space during the pandemic and now practice by telehealth exclusively. How should I proceed?

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.

Does the Academy have an online reimbursement discussion forum?

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.

MAND has a Nutrition Services Payment Specialist, Divya Aggarwal, who may be contacted for more information regarding payment and reimbursement. To send a question, please email publicpolicy@eatrightma.