Expanding Services to Additional Sites

AADE has now defined sites to better meet the needs of its programs. This change should make identifying your sites easier, marketing of your sites clear, and reimbursement less confusing to your payers.

Community Sites

Community Site - For DSME programs that wish to expand accessibility to their community.   Community Sites offer the same program as the main location and are simply an extended copy of the accredited diabetes education program.   All billing for these services goes through the main location.  These sites are not posted on the website and will not receive a separate accreditation certificate.   

  • No additional cost
  • Copy of the same program with minor alterations for specific target population needs
  • Same quality coordinator
  • No separate certificate needed
  • No location website posting

A note about hospital-based programs who want to expand into the community: 

CMS stated in the CY 2017 Proposed Physician Payment Rule: “when the DSMT services are furnished by an entity that is a hospital outpatient department (HOPD), these DSMT services must be furnished in the hospital (including a provider-based department) and cannot be furnished at alternate non-hospital locations. 

No further clarification has been provided by CMS at a national level. It is recommended that you reach out to your local Medicare Administrative Contractor (MAC) for further clarification. Learn more about MACs.

Branch Location

Branch Location - For DSME programs that wish to establish another educational location that would operate semi-independently from the primary program base location. 

These locations must be establishments within the same healthcare system entity. They fall under the original program’s oversight structure and are required to follow all accreditation guidelines established by AADE and the program.   

Branches must have the same program coordinator, and the same stakeholder group. All communications between AADE DEAP for the branches and program as a whole will go through the program coordinator. It is the responsibility of the program coordinator to distribute information as needed.  

Because of their semi-independent nature, these locations have the potential to be audited even if the main location is not chosen. Branch locations get a customized certificate and can bill separately. Certificates for branch sites have the same ID number and name as the main diabetes education site.  All of the branches are listed on the AADE website. Each branch location requires an additional $100 fee for processing and administrative oversight. Branch locations cannot be from a different business entity umbrella.

  • $100 fee per location
  • Extension of the same program, but run semi-independently and altered for specific target population
  • Website posting
  • Same quality coordinator
  • All change of status reports and other communications are submitted by the Quality Coordinator
  • Can have different staff
  • Can have different target population
  • May be audited

 

Corporations and Large Organizations

Due to necessary regulatory and oversight provisions, corporate and commercial entities wishing to seek accreditation for multiple locations need to contact AADE for further discussion and pricing. 

 

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