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Diabetes self-management training (DSMT) is an education program that can be provided to eligible newly diagnosed Medicare beneficiaries.
Patients are eligible for 10 hours within the first year of diagnosis and then 2 hours each year thereafter. Education can be provided via group sessions (> 2 patients) or individually, though individual education must be justified.
G0108, individual, per 30 minutes and G0109, group session, per 30 minutes
Who Is Covered?
Certain Medicare beneficiaries when all of the following are true:
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
Opportunities for Consultant Pharmacists to Use the Codes
DSMT probably has the most difficult criteria to meet since the organization must be accredited by either the ADA or AADE.
However, overall gaining accreditation isn’t too difficult and if you are partnering with a provider who sees many diabetic patients helping them gain accreditation opens up an additional revenue stream.
Once accreditation has been established you can partner with the physician to provide DSMT.
Remember, DSMT must be ordered by the provider first. Then the pharmacist can deliver the service. It does not require a collaborative practice agreement unless you are making changes to the patients therapies.
Just as with the diabetes prevention programs, if monitoring patient data such as blood sugar, weight, or physical activity electronically you can also utilize the remote patient monitoring code.
The next opportunity we'll discuss is Medical Nutrition Therapy.
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ABOUT THE AUTHOR:
Amy Henneman, PharmD, BCACP, BCPS, CDE is an associate professor of pharmacy practice living in south Florida with her husband and two children. Her practice has been focused in building ambulatory care services and working to provide expanded care to low income patients. She enjoys working with both providers and other pharmacists to assist them in offering expanded pharmacy services.
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