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Diabetes self-management education and support

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Diabetes Self-Management Education and Support, or DSMES, teaches participants how to:

  • eat healthy
  • be active
  • monitor blood sugar levels
  • take medication
  • problem solve
  • reduce risk for other health conditions
  • cope with their disease.

It is evidence-based and improves clinical outcomes, health status, and quality of life.

There are two accrediting organizations recognized by the Centers for Medicare and Medicaid Services (CMS). Colorado Medicaid follows the CMS policy of requiring accreditation from one of these programs:

Staff Requirements

At least one of the team members responsible for facilitating DSMES services must be ONE of the following:

  • Registered Nurse (RN)
  • Registered Dietitian/Nutritionist (RD/RDN)
  • Pharmacist with training and experience pertinent to DSMES (PharmD)
  • Healthcare professional holding certification as a Diabetes Care and Education Specialists (CDCES) or a Board Certification in Advanced Diabetes Management (BC-ADM) 
Please note:
  • Other members of the healthcare team may contribute to the provision of DSMES services with appropriate training in DSMES and with supervision and support by at least one of the team members listed above.
For more info

For more information on staff requirements and continuing education requirements for your DSMES team see Standard 3 of the 2022 National Standards for DSMES: DSMES Team.

Curriculum

Examples of existing curricula that meet Standard 4 of the 2022 National Standards for DSMES.  

Please note: this is not a comprehensive list.

 

 

The typical benefit for DSMES is 1 hour of individual and 9 hours of group education within the initial year, and 2 hours of DSMES (individual or group) each year after. (This may vary by private payers).

Colorado Medicaid
Medicare
Private Payers
  • We recommend contacting private payers directly, as coverage varies.
Telehealth
Medicare Coverage for Telehealth
  • Medicare covers individual and group DSMT* and MNT telehealth sessions when: 1) injection training is not required 2) Medicare beneficiaries reside in rural health professional shortage areas
  • *CMS uses the term “training” (DSMT) instead of “education and support” (DSMES) when defining the reimbursable Medicare billing benefit.
  • More information on the CMS benefit policy for telehealth can be found beginning on page 147 of the Medicare Claims Processing Manual.
  • Note: Due to the COVID-19 Public Health Emergency, Medicare has introduced some temporary flexibilities to telehealth services. Refer to pages 86-89 of the Covid 19 FAQs on Medicare Fee-for-Service (FFS) Billing document:
Medicaid Coverage for Telehealth
  • DSMES via telehealth is a Colorado Medicaid covered benefit.
  • Non-physician providers are now authorized to provide health education services (the provision of counseling, referral, instruction, suggestions, and support to maintain or improve health) under general supervision of a provider; direct supervision is no longer required as long as the supervising provider is immediately available via audio/visual or audio.
Medical Nutrition Therapy (MNT)
  • MNT is defined as a “nutrition-based treatment provided by a registered dietitian nutritionist” (DSMES Toolkit: MNT). 
  • The MNT benefit is a completely separate, yet complementary, benefit from Diabetes Self-Management Training (DSMT). MNT can reduce A1C by up to 2%, making it an essential component of initial and ongoing diabetes care. 
  • Studies have shown that DSMT and MNT are more effective together than either service would be if offered alone. 
    • Note: Medicare will not reimburse DSMT and MNT if provided on the same day.

Best Practice Resources
Participant Education Resources
Marketing/Outreach Tools

Marketing and outreach is vital to DSMES sustainability. You can use these tools and resources to help you better engage providers and connect with future participants:

Join the DSMES monthly sharing calls

Are you in need of additional support? Would you like to connect with other DSMES providers in your state? 

Whether your program is brand new or has been around for years, our monthly sharing calls, facilitated by CDPHE, exist to support you.

With low utilization of DSMES services amongst Coloradans affected by diabetes, the primary purpose of the calls is to provide an opportunity for partners to discuss barriers to DSMES utilization, share successes, and identify tools that may be helpful in increasing participation in DSMES services throughout the state.

Subscribe to our DSMES email list and you will receive information and invites to our monthly calls, every third Wednesday of the month.

Nationwide Programs
Colorado Programs
  • For more detailed information on local Colorado programs, check out the 2-1-1 Colorado database to find a DSMES provider near you.

While evidence-based programs can decrease the burden of diabetes, in 2017 only 59.4% of Colorado adults with diabetes reported having ever taken a diabetes self-management class.

VISION
Diabetes Data & Statistics
State of Diabetes in Colorado
Diabetes Burden in Colorado
DSMES Conference Video
CDPHE 
30-day hospital readmission rates data
  • If you are a Medicare DSMT provider and would like to obtain data related to 30-day hospital readmissions rates in your state or community for Medicare Fee-For-Service beneficiaries with a diabetes diagnosis on index hospital discharge, please contact Meredith Koob, Sr. Quality Improvement Facilitator, Telligen at mkoob@telligen.com or by calling (303) 260-9346.

DSMES Conference Videos
Refer to DSMES

Share these resources with providers interested in referring to DSMES:

For further guidance, contact Lisa Bentley, Diabetes Management Coordinator at CDPHE: lisa.bentley@state.co.us 

 

Additional Contacts:

Association of Diabetes Care and Education Specialists (ADCES): deap@adces.org 800.338.3633 

American Diabetes Association (ADA): erp@diabetes.org 1.800.DIABETES (342.2383)

Colorado Medicaid Claims and Billing Questions: 1.844.235.2387