Association of Diabetes Care & Education Specialists

2018 MDPP Physician Fee Schedule Released

The Medicare Diabetes Prevention Program (MDPP) expanded model is a structured intervention with the goal of preventing or delaying type 2 diabetes in individuals with prediabetes. The MDPP expanded model will allow Medicare beneficiaries to receive an evidence-based diabetes prevention program, with the goal of a lower rate of progression to type 2 diabetes, improved health and reduced costs.

The program consists of a minimum of 16 intensive “core” sessions delivered over six months in a group-based, classroom-style setting that provides practical training in long-term dietary change, increased physical activity, and behavior change strategies for weight control. After completing the core sessions, follow-up meetings are delivered monthly. The primary goal of the expanded model is at least 5 percent weight loss by participants.

Diabetes Prevention – A Covered Benefit

CMS announced the National Diabetes Prevention Program (National DPP) would be a covered benefit beginning in 2018. CMS received hundreds of comments, from both AADE and diabetes educators like you, regarding coverage of the National DPP, and took many of these into consideration when establishing the final rule. 

ADCES Prevention Network

In 2017, we launched the ADCES Prevention Network, taking tools that were being used by current programs operating within our in-person diabetes prevention delivery network, and making them available to any organization that is DPRP recognized and wanting to prepare for the MDPP benefit. Based on the 2018 Physician Fee Schedule and CMS’s final ruling, we will continue to offer tools, resources, education and support along the way to assist programs in the delivery of the National DPP.

Become an MDPP Supplier

As of April 1, 2018, Medicare covers the National Diabetes Prevention Program (National DPP) for Medicare beneficiaries.  Any organization that has been providing the National DPP and has obtained preliminary or full CDC-recognition, is eligible to apply for reimbursement under the Centers for Medicare and Medicaid Services (CMS) Medicare Diabetes Prevention Program (MDPP) expanded model. 

Interested in offering diabetes prevention services but don’t know where to begin?

ADCES has developed a tool, linked below, that will walk you through the steps to becoming a Medicare Diabetes Prevention Program Supplier (MDPP), making your program eligible for Medicare reimbursement of up to $670 per participant.

Whether you are working in a healthcare system or a community-based organization, becoming a MDPP supplier generates revenue for your program and opens doors to new patients who have an indication of prediabetes.