The US health care system has been undergoing substantial changes in reimbursement for medical and nutrition services. These changes have offered opportunities and challenges for registered dietitian nutritionists (RDNs) to bill for medical nutrition therapy and other nutrition-related services. During the past 10 years, the Academy of Nutrition and Dietetics has periodically surveyed RDNs providing medical nutrition therapy in ambulatory care settings to learn about their knowledge and patterns of coding, billing, and payment for their services. In 2018, the Academy of Nutrition and Dietetics conducted the latest iteration of this survey. This article compares the results of the 2008, 2013, and 2018 surveys to examine changes in RDNs' knowledge of billing code use and reimbursement patterns over time; understand the potential influences on coding and billing practices in a changing health care environment; and understand the effects of newer practice settings and care delivery models on billing and reimbursement for medical nutrition therapy services. Results from these surveys demonstrate that during the past 10 years RDNs' knowledge of billing and coding has been stable and very low for RDNs not in supervisory roles or private practice. RDNs reported an increase in providing medical nutrition therapy services to patients with multiple conditions. Since 2013, a dramatic increase was noted in the reported proportion of reimbursement from private/commercial health insurance plans. Results also indicate that most RDNs are not aware of changes in health care payment. Individual RDNs need to understand and be held accountable for the business side of practice and their value proposition in today's health care environment.

中文翻译：

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注册营养师营养师知识和编码、计费和支付模式的趋势

美国医疗保健系统在医疗和营养服务的报销方面一直在发生重大变化。这些变化为注册营养师营养师 (RDN) 提供了为医疗营养治疗和其他营养相关服务收费的机会和挑战。在过去的 10 年中，营养与饮食学会定期调查在门诊护理环境中提供医学营养治疗的 RDN，以了解他们的知识和编码、计费和服务支付模式。2018 年，营养与饮食学会进行了最新一轮的调查。本文比较了 2008、2013 和 2018 年的调查结果，以检查 RDN 对计费代码使用和报销模式的了解随时间的变化；了解在不断变化的医疗保健环境中对编码和计费实践的潜在影响；并了解更新的实践环境和护理提供模式对医疗营养治疗服务的计费和报销的影响。这些调查的结果表明，在过去 10 年中，RDN 对计费和编码的了解一直很稳定，而且对于不担任监管角色或私人执业的 RDN 来说非常低。RDN 报告称，为患有多种疾病的患者提供医疗营养治疗服务的情况有所增加。自 2013 年以来，私人/商业健康保险计划的报销比例显着增加。结果还表明，大多数 RDN 不知道医疗保健支付的变化。