Idaho National Diabetes Prevention Program Network Opportunity
Recording of December 8, 2023, 1st Idaho National Diabetes Prevention Program Network Opportunity.
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Powerpoint Here
Agenda:
- Updated National Diabetes Prevention Program Customer Service Center
- Using HbA1C To Meet DPRP Program Requirements
- Public Health Emergency Updates
- Advanced Lifestyle Coach Training
- Network and Technical Assistance needs
Recording of January 18, 2023, 2nd Idaho National Diabetes Prevention Program Network Opportunity.
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Advanced Lifestyle Coach Training opportunities Here
DTTAC Advanced Lifestyle Coach Training opportunities Here
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Agenda:
- National Diabetes Prevention Program and Walk With Ease
- Overview of NDPP billing and common NDPP billing errors
- Advanced Lifestyle Coach opportunities for QTR #1 in 2023
- Network to share success, challenges and TA needs
Recording of March 7 , 2023, 3rd Idaho National Diabetes Prevention Program Network Opportunity
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Powerpoint Here
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Agenda
- · Recruitment and Retention in NDPP
- · Session Zero/Information Session Ideas
- · Advanced Lifestyle Coach opportunities for QTR #2 in 2023
- · Network to share success, challenges and TA Needs
Recording of May 11, 2023 4th Idaho National Diabetes Prevention Program Network Opportunitiy
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Agenda:
· Umbrella Hub Arrangement and the National DPP
· National DPP PHE Waiver Update
· Advanced Lifestyle Coach Training
- · Network to share success, challenges and TA Needs
What is the National Diabetes Prevention Program?
The National DPP lifestyle change program is founded on the science of the Diabetes Prevention Program research study, and several translation studies that followed, which showed that making modest behavior changes helped people with prediabetes lose 5% to 7% of their body weight and reduce their risk of developing type 2 diabetes by 58% (71% for people over 60 years old). The National DPP’s lifestyle change program:
•Is a year-long, structured program (in-person group, online, or combination) consisting of:
•An initial six-month phase offering a minimum of 16 sessions over 16–24 weeks and
•A second six-month phase offering a minimum of one session a month (at least six sessions).
•Is facilitated by a trained Lifestyle Coach.
•Uses a CDC-approved curriculum.
•Includes regular opportunities for direct interaction between the Lifestyle Coach and participants.
•Focuses on behavior modification, managing stress, and peer support.
Find a local Idaho National Diabetes Prevention Program here at https://dprp.cdc.gov/Registry
New!!
Guidance to MDPP Suppliers on Payment Transition
Updated 12/20/2023
Purpose of this Document: To help MDPP suppliers transition between the CY 2023 and CY 2024 payment schedules.
In the Calendar Year (CY) 2024 Physician Fee Schedule (PFS) published on November 16, 2023, Centers for Medicare & Medicaid Services (CMS) finalized that Medicare Diabetes Prevention Program (MDPP) suppliers may continue to offer the set of MDPP services virtually, using distance learning delivery, through December 31, 2027. As part of the final rule, CMS updated the MDPP payment structure with fee-for-service (FFS) payments for attendance while maintaining the weight loss performance payments.1 All of these updates go into effect on January 1, 2024.
All claims with dates of service (DOS) on or before December 31, 2023 should follow the CY 2023 Fee Schedule (Table 2). All claims with DOS on or after January 1, 2024 should follow the CY 2024 Fee Schedule, claims must be submitted within one year from the DOS. MDPP suppliers with cohorts that started in 2023 and will end in 2024 are required to transition to the CY 2024 Fee Schedule (Table 1) for all DOS on or after January 1, 2024.
The following instructions and examples illustrate how to: count MDPP sessions attended CY 2023, calculate the MDPP services period, understand what happens when a CY 2023 claim is submitted out of sequence in CY 2024, and count the remaining sessions in CY 2024 for each MDPP participant.
NOTE: To limit the need for claims reprocessing and potential recoupment of payments made in error, MDPP suppliers should consider submitting their claims with DOS in CY 2023 as soon as possible. As a reminder, suppliers have 12 months from the date of service to submit a claim to their MACs.
Please contact the MDPP Supplier Support Center (https://cmsorg.force.com/mdpp) with any questions.
Table 1. CY 2024 MDPP Payment Schedule
|
HCPCS G-Code |
Payment Description* |
CY 2024 |
|
G9886* |
Behavioral counseling for diabetes prevention, in-person, group, 60 minutes |
$25 |
|
G9887* |
Behavioral counseling for diabetes prevention, distance learning, 60 minutes |
$25 |
|
G9880 |
5 percent weight loss achieved from baseline weight |
$145 |
|
G9881 |
9 percent weight loss achieved from baseline weight |
$25 |
|
G9888** |
Maintenance 5 percent weight loss from baseline in months 7-12 |
$8 |
|
G9890*** |
Bridge payment |
$25 |
|
Total Maximum Payment |
$768 |
*Medicare pays up to 22 sessions billed with codes G9886 and G9887, combined, in a 12-month period: Months 1-6: 1 in-person or distance learning session every week (max 16 sessions)
Months 7-12: 1 in-person or distance learning session every month (max 6 sessions)
** MDPP suppliers must submit claim for 5 percent weight loss (G9880) prior to submitting claims for the maintenance 5 percent Weight Loss from baseline in months 7-12 (G9888).
***Note that the bridge payment does not count towards the 22 MDPP sessions payable in CY 2024.
Full details here