Medicare Claims Processing Manual (Pub. 100-04), Ch. 9 § 70.4

Diabetes Self-Management and Training (DSMT) and Medical

Last amended: 2025Year: 2025Length: 106 wordsOfficial source
70.4 - Diabetes Self-Management and Training (DSMT) and Medical Nutrition Services (MNT) (Rev. 13264, Issued:06-09-25; Effective: 06-02-25; Implementation: 06-02-25) FQHCs billing under the PPS DSMT and MNT are qualifying visits when billed under G0466 or G0467. For additional information on the payment specific codes and qualifying visits, see section 60.2 of this manual. Under the FQHC PPS, DSMT and MNT do not qualify for a separate payment when billed on the same day with another qualified visit. RHCs RHCs are not paid separately for DSMT and MNT services. All line items billed on TOB 71X with HCPCS codes for DSMT and MNT services will be denied.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 9 § 70.4: Diabetes Self-Management and Training (DSMT) and Medical | Justis AI