Your Medicare Coverage

Is my test, item, or service covered?

Diabetes self-management training

How often is it covered?

Medicare Part B (Medical Insurance) covers outpatient diabetes self-management training (DSMT) to teach you to cope with and manage your diabetes. It includes tips for eating healthy, being active, monitoring blood sugar, taking drugs, and reducing risks. Medicare may cover up to 10 hours of initial DSMT. This training may include 1 hour of individual training and 9 hours of group training. You may also qualify for up to 2 hours of follow-up training each year if it takes place in a calendar year after the year you got your initial training.

Who's eligible?

This training is for certain people with Part B who are at risk for complications from diabetes. You must have a written order from a doctor or other health care provider.

Some exceptions apply if group sessions aren't available or if your doctor or qualified non-doctor practitioner says you have special needs that would be better met by individual training sessions.

If you’re in a rural area, you may be able to get DSMT services from a practitioner, like a Registered Dietician, in a different location through telehealth

Your costs in Original Medicare

You pay 20% of the Medicare-approved amount, and the Part B deductible applies.

Note

To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:

  • Other insurance you may have
  • How much your doctor charges
  • Whether your doctor accepts assignment
  • The type of facility
  • Where you get your test, item, or service

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