Diabetes Prevention & Self-Management Resources

Take Advantage of Your Medicare and Medicaid Diabetes Management Benefits.

DIABETES PREVENTION PROGRAM (DPP)

Medicare Part B and Medicaid Covers Diabetes Prevention if You Have the Following Conditions:

  • Fasting Plasma Glucose: 110-125mg/dL

  • Oral Glucose Tolerance Test: 140-199 mg/dL

  • A1c 5.7-6.4%

  • Body Mass Index (BMI): 25 or More (BMI of 23 or More if You’re Asian).

  • You've Never Been Diagnosed with Type 1 or Type 2 Diabetes or End-Stage Renal Disease.

  • Medicare Advantage Plan Member? - Contact Your Plan to Determine if You are Restricted to an In-Network DPP Provider.

Did You Know Gateway Region YMCA Provides DPP Classes? Contact the GWRYMCA Today. You May Be Asked for the Following Information:

  • Physician’s National Provider Identifier (NPI)

  • Your Height & Weight (BMI 25 or Higher)

  • ICD-10 Diagnosis Code:

    • R73.01 Impaired Fasting Glucose

    • R73.02 Impaired Glucose Tolerance

    • R73.03 Prediabetes

  • Most Recent A1c Lab Results

  • Medicare / Medicaid Insurance Card

Getting Started

DIABETES SELF-MANAGEMENT TRAINING (DSMT) / DIABETES SELF-MANAGENT EDUCATION & SUPPORT (DSMES)

Medicare Part B (Diabetes Self-Management Training) and Illinois Medicaid (Diabetes Self-Management Education and Support) Covers Diabetes Self-Management Education if You Have the Following Conditions:

  • Type 2 Diabetes A1c 6.5% or higher

  • Chronic Kidney Disease (CKD)

  • You’ve Had a Kidney Transplant in the Last 36 Months.

DSMT Training Also Provides:

  • 3 Hours of One-on-One Medical Nutrition Therapy (MNT) Per Calendar Year by a Registered Dietitian Nutritionist.

  • 2 Additional Hours Can Be Requested the Following Year by Primary Care Physician or Medical Doctor (ie. Medical Condition Changes, Worsening Symptoms, etc.

Getting Started

DSMT/DSMES Classes are Conducted at the Barnes Jewish Memorial Hospital Center for Diabetes Education.

For Information Regarding Upcoming Classes Contact Dina Chapman via E-mail: dina.chapman@bjc.org or phone: 618.257.4800 or 618.257.6616. You Will be Asked for the Following Information:

  • Nurse Practitioner’s or Doctor’s (MD or DO) NPI

  • Labs Reflecting A1c 6.5% or higher

  • ICD-10 Diagnosis Code:

    • E11.9 Type 2 Diabetes

    • E11.22 Type 2 Diabetes with CKD

To Get Started with Individual MNT with a Dietitian Ask Your Doctor to Forward the Referral to My HIPAA Secure Fax: 618.227.9963, with the Following Information:

  • Nurse Practitioner’s or Doctor’s (MD or DO) NPI

  • Labs Reflecting A1c 6.5% or higher

  • ICD-10 Diagnosis Code:

    • E11.9 Type 2 Diabetes

    • E11.22 Type 2 Diabetes with CKD

  • Medicare / Medicaid Insurance Card