Intensive Behavioral Therapy (IBT) for Obesity

The Centers for Disease Control (CDC) reported that “obesity rates in the U.S. have increased dramatically over the last 30 years, and obesity is now epidemic in the United States.” In the Medicare population over 30 percent of men and women are obese. Obesity is putting a strain on American families, affecting overall health, health care costs, productivity and military readiness.

Obesity is serious because it is associated with poorer mental health outcomes and reduced quality of life. In the United States and worldwide, obesity is also associated with the leading causes of death, including deaths from diabetes, heart disease, stroke and some types of cancer.

Obesity is a common, serious and costly disease

• From 1999–2000 through 2017 – March 2020, U.S. obesity prevalence increased from 30.5 percent to 41.9 percent. During the same time, the prevalence of severe obesity increased from 4.7 percent to 9.2 percent. (NHANES, 2021)
• Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer. These are among the leading causes of preventable, premature death.
• The estimated annual medical cost of obesity in the U.S. was nearly $173 billion in 2019 dollars. Medical costs for adults who had obesity were $1,861 higher than medical costs for people with healthy weight.
• Non-Hispanic Black adults (49.9 percent) had the highest age-adjusted prevalence of obesity, followed by Hispanic adults (45.6 percent), non-Hispanic White adults (41.4 percent) and non-Hispanic Asian adults (16.1 percent)
• The obesity prevalence was 39.8 percent among adults aged 20 to 39 years, 44.3 percent among adults aged 40 to 59 years, and 41.5 percent among adults aged 60 and older

Based upon authority to cover “additional preventive services” for Medicare beneficiaries if certain statutory requirements are met, the Centers for Medicare & Medicaid Services (CMS) initiated a national coverage analysis on intensive behavioral therapy for obesity. Screening for obesity in adults is recommended with a grade of B by the U.S. Preventive Services Task Force (USPSTF) and is appropriate for individuals entitled to benefits under Part A and Part B.

Refer to NCD - Intensive Behavioral Therapy for Obesity (210.12) for more information or to Palmetto GBA for further questions. 

Resources 

• CDC — Overweight & Obesity
   
• CMS National Coverage Determination — NCD - Intensive Behavioral Therapy for Obesity (210.12) 
   
• CMS Preventive Services Intensive Behavioral Therapy (IBT) for Obesity — MLN006559 – Medicare Preventive Services 
   
• Palmetto GBA Medicare Administrative Contractor (MAC) — Palmetto GBA