Diabetic, Diabetes Self-Management Training (DSMT) and Medical Nutrition Therapy (MNT) Services
Medicare provides coverage of diabetes screening tests for beneficiaries at risk for diabetes or those diagnosed with pre-diabetes.
Access the below related information from this page.
- Diabetes Self-Management Training (DSMT)
- Medical Nutrition Therapy (MNT)
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Coverage is provided for beneficiaries who have been recently diagnosed with diabetes, were determined to be at risk for complications from diabetes, or were previously diagnosed with diabetes before meeting Medicare eligibility requirements and have since become eligible for coverage under the Medicare Program when a certified provider who meets certain quality standards furnishes these services.
- G0108 – DSMT, individual, per 30 minutes
- G0109 – DSMT, group (2 or more), per 30 minutes
- No specific diagnosis code
- Contact local Medicare Administrative Contractor (MAC) for guidance
- Initial year: Up to 10 hours of initial training within a continuous 12-month period; or
- Subsequent years: Up to 2 hours of follow-up training each year after initial year
- Copayment/coinsurance applies
- Deductible applies
Coverage is provided for beneficiaries diagnosed with diabetes and/or renal disease (except for those receiving dialysis) and post renal transplant when provided by a registered dietitian or nutrition professional who meets provider qualifications requirement. Three hours of MNT is covered in first year and two hours in subsequent years, and additional hours in certain situations.
- CMS Internet Only Manual (IOM), Publication 100-02, Medicare Benefit Policy Manual, Chapter 15, Section 270.4.3 and 300
- CMS IOM, Publication 100-04, Medicare Claims Processing Manual, Chapter 18, Section 90
- CMS IOM, Publication 100-04, Medicare Claims Processing Manual, Chapter 4, Sections 300
- CMS Medicare Learning Network (MLN) Matters Special Edition (SE)1113 - Foot Care Coverage Guidelines
- CMS National Coverage Determination (NCD) 180.1 for MNT
Last Updated Jul 28, 2017
The below are topic specific articles which have been published to "Latest Updates" and sent out in Noridian emails within the past two years. Exclusions to this include time sensitive related announcements such as: Noridian and CMS educational events, Ask-the-Contractor Teleconferences and claims processing downtime.