Diabetes Self-Management Education and Support
Resources
The following resources can assist you by providing more information about Diabetes Self-Management Education and Support programs. The resources are divided into three sections - Resources for Implementing DSMES, Curriculum Options for DSMES, and Handouts to use for DSMES program participants and people with diabetes.
Resources for Implementing DSMES
The following resources provide information about implementing a DSMES program.
- ADA DSMES Algorithm of Care - provides guidance on four critical times to assess, provide, and adjust diabetes self-management education and support.
- ADA DSMES – Action Steps - provides primary care/endocrinologist/clinical care team and diabetes education action steps during four clinical times to assess, provide, and adjust diabetes self-management education and support.
- ADA Standards of Care (2019) - contains up to date recommendations for the identification and treatment of diabetes.
- ADCES. Tools for Diabetes Educators - this website includes clinical management tools for complications and co morbidities including cardiovascular resources, blood glucose monitoring resources, insulin pump therapy resources, medication taking resources, etc.
- American Heart Association- Know Diabetes by Heart- Target: Type 2 Diabetes for Ambulatory Practices - this website provides information for outpatient providers and ambulatory health centers and systems to improve care and reduce patient risk factors for type 2 diabetes and cardiovascular disease.
- Quality Coordinator Guide - For getting started with a DSME Program, this Quality Coordinator Guide provides a detailed guide for each of the 10 NSDSME standards, complete with templates and examples of required documentation.
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For 1:1 technical assistance for DSME programs, the ADA provides free regularly scheduled calls as well as a
Newsletter and archive of previous editions.
Curriculum Options for DSMES
The following resources provide curriculum resources for DSMES programs.
Handouts to use with DSMES program participants
The following resources are booklets, guides, and handouts that can be provided to DSMES participants or people with diabetes.
- Patient Education Materials Library
- AMA’s Diabetes Prevention Guide
- Living with Type 2 Diabetes Program - The “Living with Type 2 Diabetes” program is a great free supplemental resource for DSME programs. It could be utilized as an option for the Diabetes Self - Management Education and Support (DSMES) plan and/or provided as a option for individuals not yet ready and/or eligible to participate in a DSME program.
Research Articles
The following research articles can assist you with further learn about
Diabetes Self-Management Education and
Support Services.
- Adjei Boakye, E., Varble, A., Rojek, R., Peavler, O., Trainer, A. K., Osazuwa-Peters, N., & Hinyard, L. (2018). Sociodemographic Factors Associated With Engagement in Diabetes Self-management Education Among People With Diabetes in the United States. Public Health Reports, 133(6), 685–691. https://doi.org/10.1177/0033354918794935.
- Andes LJ, Li Y, Srinivasan M, Benoit SR, Gregg E, Rolka DB. Diabetes Prevalence and Incidence Among Medicare Beneficiaries — United States, 2001–2015. MMWR Morb Mortal Wkly Rep 2019;68:961–966. DOI: http://dx.doi.org/10.15585/mmwr.mm6843a2.
- Beck J., Greenwood D.A., Blanton L., Bollinger S.T., Butcher M.K., Condon J.E., Cypress M., et al. 2017 National Standards For Diabetes Self-Management Education and Support. The Diabetes Educator. 2017; 44, no. 1 (2018): 35-50 https://doi.org/10.1177/0145721718754797.
- Carter E.L., Nunlee-Bland G., Callender C. A Patient-Centric, Provider-Assisted Diabetic Telehealth Self-management Intervention for Urban Minorities. Perspectives in health information management/AHIMA, American health information management association 2011; 8(0).
- ChangeLab Solutions. California: Background, Benefits, and Insurance Coverage of DSME/T. August 1, 2016.
- ChangeLab Solutions. National Landscape: Background, Benefits, and Insurance Coverage of DSME/T. August 1, 2016.
- Daskivich, L. P., Vasquez, C., Martinez, C., Tseng, C. H., Mangione, C. M. (2017). Implementation and evaluation of a large-scale teleretinal diabetic retinopathy screening program in the Los Angeles County Department of Health Services. JAMA internal medicine, 177(5), 642-649.
- Gutierrez, A. P., Fortmann, A. L., Savin, K., Clark, T. L., & Gallo, L. C. (2019). Effectiveness of Diabetes Self-Management Education Programs for US Latinos at Improving Emotional Distress: A Systematic Review. The Diabetes Educator, 45(1), 13–33. DOI:10.1177/0145721718819451.
- Lyonnais MJ, Bray P, Rafferty, AP, Winterbauer, NL, Bell, RA. Potential Effect of Vouchers on the Completion of Self-management Education Among Patients With Diabetes. Journal of Public Health Management and Practice, 2019 February. 3-4. doi: 10.1097/PHH.0000000000000985.
- Mensing, C. Comparing the Processes: Accreditation and Recognition. Diabetes Spectrum, 2010; 23(1), 65-78.
- Rinker, J and Wolf, M. N.C. Diabetes Education Recognition Program: ADA Recognition for a Combined Program at Local Health Departments and Community Health Centers in North Carolina. Clinical Diabetes. 2012; 30(3), 110 - 114.
- Silveira L.J., Fleck S.B., Sonnenfeld N., Manna J., Zhang L., Irby K.B., Brock J.E. Estimated Cost Savings Everyone with Diabetes Counts (EDC) Program. Family and Community Health. 2018 July - September; 42(3), 185 - 193. doi:10.1097/FCH.0000000000000189.
- Spencer, MS, Rosland A, Kieffer EC, Sinco BR, Valerio M, Palmisano G, Anderson M, Guzman JR, and Heisler M. Effectiveness of a Community Health Worker Intervention Among African American and Latino Adults With Type 2 Diabetes: a Randomized Controlled Trial. American journal of Public Health. 2012, December; 101, no. 12 (2011): 2253-2260. doi: 10.2105/AJPH.2010.300106.
Coverage and Billing
If you are a community-based organization that provides diabetes services or a healthcare provider, understanding how to bill for diabetes-related services relieves some of the burden from your patient/client. Here are some resources to assists you with navigating billing.
Medicare
The Centers for Medicare and Medicaid Services (CMS) provides reimbursement for diabetes self-management training (DSMT). Medicare Part B covers both the initial and follow-up outpatient diabetes self-management training (DSMT), which includes 10 initial hours of DSMT and 2 hours of follow-up DSMT. Each session is at least 30 minutes face to face session.
- Medicare Billing for DSME/MNT Services
- ADCES – FQHC and DSMT Frequent Asked Questions
- International Classification of Disease (ICD) – 9 and ICD – 10 Billing Codes for diabetes
- Centers for Medicare and Medicaid Services (CMS) reimbursement rates for DSMT
- National Council on Aging - Diabetes Self-Management Training Tip Sheet for Medicare Accreditation and Reimbursement
- National Council on Aging - Webinar recording: Diabetes Self Management Training: How it Benefits Seniors and Steps to Reimbursement (PowerPoint slides available)
- National Council on Aging - Webinar recording: Obtaining Diabetes Self-Management Accreditation and Medicare Reimbursement: What States Need to Know (PowerPoint slides available)
Medi-Cal
Effective April 1, 2016, the following DSMT HCPCS code are Medi-Cal benefits:
Code | Description |
---|---|
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 |
Private Insurance
Private insurance plans are required to cover DSME/T services. Please contact your provider for more information.
Federally Qualified Health Centers
Below are some resources specific to billing and reimbursement for DSMES in FQHCs:
- Medicare Claims Processing Manual - direct link to coverage in FQHC
- Specific Payment Codes for FQHCs - describes specific payment codes for FQHCs, including for DSMT
Toolkits
- 2024 Toolkit and Resource Guide: Diabetes Self-Management Education and Support (DSMES)Services and National Diabetes Prevention Programs (National DPP) and the Community Pharmacy -a toolkit designed for community pharmacies interested in developing and implementing Diabetes Self-Management Education and Support Services and National Diabetes Prevention Program.
- Diabetes Self-Management Education and Support (DSMES) Toolkit 2023 -a toolkit designed for current program providers, clinicians, health system administrators, and anyone interested in developing and implementing Diabetes Self-Management Education and Support Services based on the 2022 National Standards.
- Centers for Disease Control and Prevention Diabetes Self-Management Education and Support (DSMES) Toolkit (2018) - a comprehensive resource for increasing use of DSMES among with people with diabetes and promote healthcare provider referrals. The toolkit provides resources and tools to assist with the development, promotion, implementation, and sustainability of DSMES services
- Centers for Medicare and Medicaid Services - Diabetes Self-Management Education/Training Reimbursement Toolkit (October 2013)
Recognition and Accreditation
If you are seeking reimbursement for diabetes education, you must get recognition from the American Diabetes Association (ADA) or accreditation from the Association of Diabetes Care & Education Specialists (ADCES). Here are some resources to learn more about the process of recognition or accreditation for your DSMES program.
American Diabetes Association (ADA)
- Education Recognition Program (ERP) - this resource provides information on first steps of the ADA recognition process and information on maintaining recognition. The review process may take up to 30 days after the receipt of all materials.
- Recognition Requirements - provides an FAQ about the ADA requirements for recognition.
- New Application Checklist - provides a checklist of information and documentation to gather to help prepare for the ADA Recognition Program application.
- Support Documentation Checklist - provides a checklist of support documentation needed for the ADA Recognition Program. Support documentation must be received within 14 calendar days of the online application submission.
- Application Fees - provides information about different possible methods of payment when applying for the ADA Recognition Program.
- Education Recognition Program Portal Walkthrough - a guide that provides step-by-step instructions on how to use the Education Recognition Program Portal
Templates
Use the following templates to help you prepare to apply for the ADA Recognition Program:
- Application Template
- Renewal Application Template
- Expansion Application Template -
- Multi-site Application Template
If you have any questions, please email ERP@diabetes.org call (888)-232-0822.
Association of Diabetes Care and Education Specialists(ADCES)
- Learn More about the Diabetes Education Accreditation Program (DEAP) - resource to help you learn more about the ADCES DEAP and the process of applying.
- Ready to Apply to DEAP - information includes video about how to apply for DAP and FAQs about applying.
- Start DEAP Application - when your organization is ready to apply for ADCES accreditation, you can create an online account to submit your application.
- Currently DEAP Accredited - provides information to help your organization maintain accreditation, including participants and billing, staffing, changes in status, data reporting, and annual updates.
- Resource Guide to help address Social Needs
- DEAP Policies - provides specific information that help clarify the various requirements and processes relating to site visits, reaccreditation, appeals, and complaints.
If you have any questions related to DEAP, please email deap@aadenet.org or call (800) 338-3633