Diabetes Self-Management Training (DSMT) - JF Part A

HCPCS/CPT Codes

• G0108 - DSMT, individual, per 30 minutes
• G0109 - DSMT, group (two or more people), per 30 minutes

Frequency

Initial Year: Up to 10 hours of initial training within a continuous 12-month period

Subsequent Years: Up to two hours of follow-up training each year after the initial year

Coverage

Beneficiary must meet both of the following:

• Diagnosed with diabetes
• Receive order for DSMT from physician or qualified non-physician practitioner treating beneficiary's diabetes

Payment

Copayment/coinsurance applies; Deductible applies

Noridian Medicare Portal

No

Resources

• CMS Internet Only Manual (IOM), Publication 100-02, Medicare Benefit Policy Manual, Chapter 15, Section 300
• CMS IOM, Publication 100-04, Medicare Claims Processing Manual, Chapter 18, Section 120
• CMS Medicare Preventive Services
• CMS National Coverage Determination (NCD) 180.1