September 1st, 2017
The following information from the Medicare Learning Network provides guidance from the Department of Health and Human Services on Diabetes Self-Management Training:
|G0108 -||Diabetes outpatient self-management training services, individual, per 30 minutes|
|G0109 -||Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes|
Who Is Covered
Certain Medicare beneficiaries when all of the following are true:
- Diagnosed with diabetes
- Receive an order for DSMT from the physician or qualified NPP treating the Medicare beneficiary's diabetes
- Initial year: Up to 10 hours of initial training within a continuous 12-month period
- Subsequent years: Up to 2 hours of follow-up training each year after the initial year
Medicare Beneficiary Pays
- Copayment/coinsurance applies
- Deductible applies
- Refer to Provider Compliance Tips for Diabetic Test Strips for more information.
Please note: The information in this educational product applies only to the Medicare Fee-For-Service Program (also known as Original Medicare). For additional guidance on using diagnosis codes, go to the Medicare Claims Processing Manual, Chapter 18 on the Centers for Medicare & Medicaid Services (CMS) website.
Watch the CMS Provider Minute: Preventive Services video for pointers to help you submit sufficient documentation when billing for certain preventive services.