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US · guidance

CMS Pub. 100-04, ch. 18, § 120.1

Coding and Payment of DSMT Services

activein force · 2026-08-25 – presentas-observed

The following HCPCS codes are used to report DSMT:

• G0108 - Diabetes outpatient self-management training services, individual, per 30 minutes.

• G0109 - Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes.

The type of service for these codes is 1.

Payment to physicians and providers for outpatient DSMT is made as follows:

Type of Facility Payment Method Type of Bill

Physician (billed to

the A/B MAC (B))

MPFS NA

Hospitals subject to

OPPS

MPFS 12X, 13X

Method I and Method

II Critical Access

Hospitals (CAHs)

(technical services)

101% of reasonable cost 12X and 85X

Type of Facility Payment Method Type of Bill

Indian Health Service

(IHS) providers

billing hospital

outpatient Part B

OMB-approved

outpatient per visit all

inclusive rate (AIR)

13X

IHS providers billing

inpatient Part B

All-inclusive inpatient

ancillary per diem rate

12X

IHS CAHs billing

outpatient Part B

101% of the all-inclusive facility

specific per visit rate

85X

IHS CAHs billing

inpatient Part B

101% of the all-inclusive facility

specific per diem rate

12X

FQHCs* All-inclusive encounter

rate with other qualified

services. Separate visit

payment available with

HCPCS.

73X

Skilled Nursing

Facilities **

MPFS non-facility rate 22X, 23X

Maryland Hospitals

under jurisdiction of

the Health Services

Cost Review

Commission

(HSCRC)

94% of provider

submitted charges in

accordance with the

terms of the Maryland

Waiver

12X, 13X

Home Health

Agencies (can be

billed only if the

service is provided

outside of the

treatment plan)

MPFS non-facility rate 34X

* Effective January 1, 2006, payment for DSMT provided in an FQHC that meets all of the requirements as above,

may be made in addition to one other visit the beneficiary had during the same day, if this qualifying visit is billed on

TOB 73X, with HCPCS G0108 or G0109, and revenue codes 0520, 0521, 0522, 0524, 0525, 0527, 0528, or 0900.

** The SNF consolidated billing provision allows separate part B payment for training services for beneficiaries that

are in skilled Part A SNF stays, however, the SNF must submit these services on a 22 bill type. Training services

provided by other provider types must be reimbursed by X the SNF.

NOTE: An ESRD facility is a reasonable site for this service, however, because it is required to provide dietician and

nutritional services as part of the care covered in the composite rate, ESRD facilities are not allowed to bill for it

separately and do not receive separate reimbursement. Likewise, an RHC is a reasonable site for this service,

however it must be provided in an RHC with other qualifying services and paid at the all-inclusive encounter rate.

Deductible and co-insurance apply.

History

(Rev. 1255, Issued: 05-25-07; Effective: 07-01-07; Implementation: 07-02-07)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
b3eba7c4a860e6ec87ccb535034ffcb4220ef28fc433ed2a398ae6ac72688746
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