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Treatment of Obesity

Current language in Pub. 100-03, National Coverage Determinations Manual (NCDM) states “obesity itself cannot be considered an illness.” This language is being removed, and the remaining language revised, as the NCDM is intended to address the coverage of particular care and services rather than the definition of illness. The change in the manual language will not directly affect current Medicare coverage of obesity treatments. Services in connection with the treatment of obesity are covered services only when an integral and necessary part of a course of treatment for a medical condition. Treatment of obesity unrelated to such a medical condition remains non-covered.

Download the Guidance Document

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: October 01, 2004

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.