DSMES Learning Series: DSMT Reimbursement

February 16, 2021

There is no cost to attend this webinar but registration is required. 


Once you're logged in, please select the green "ENTER" button found in the course summary box. After you register, you'll receive an email with instructions on how to complete your registration through Zoom.

If you have questions, please email Laurene Hendricks at laurene.hendricks@idph.iowa.gov.

Upcoming DSMES Webinars

January 12  Tools to Maximize Virtual and Live Patient Learning and Behavior Change and Provider Communications

March 23  Remote Patient Monitoring Reimbursement

Target Audience

DSMES program staff.


This presentation will discuss current Medicare coverage guidelines including those related to DSMES/T referrals, lab criteria, utilization limits in first and follow-up years, structure of initial and follow-up benefits, beneficiary entitlement, provider eligibility, DSMES/T telehealth, procedure, diagnosis and revenue codes for accurate claims, quality standards, allowed practice settings, and the benefits/tiered payment rates. Attendees will receive a modifiable referral form that is designed to be Medicare-compliant, created to increase reimbursement success and quality assurance, and a 10 Step Plan to Increase Private Payer Reimbursement Success.

Learning Objectives

  • Describe Medicare beneficiary eligibility for DSMT.
  • List three of the key Medicare coverage guidelines for telehealth DSMT.
  • Describe the key Medicare coverage guidelines for DSMT.


RENDERING PROVIDER ELIGIBILITY: Individual, entity, billing for another Medicare benefit first

BENEFICIARY ELIGIBILITY: Part B insurance, labs, ICD-10 dx codes

QUALITY STANDARDS: NSDSMES, ADCES accreditation, and ADA recognition

REFERRAL REQUIREMENTS: Required documentation and referring provider eligibility

STRUCTURE of INITIAL and F/UP BENEFIT: Utilization limits, sites and regulations, time frames, individual and group hours, and criteria for all individual

BILLING and CODING: Billing providers, procedure, revenue, and ICD-10 codes

PLACES OF SERVICE: Allowed and prohibited



TELEHEALTH DSMT: Originating vs. distant sites, allowed rendering and billing providers, and key billing requirements

Educational Need

  • Identified gap(s): Successful insurance reimbursement for DSMES/T is critical for sustaining DSMES/T programs. DCESs are lacking in knowledge of the specific required Medicare and private payer coverage guidelines for DSMES/T.
  • Description of current state: DCESs should be responsible for the financial management of their DSMES/T programs, and this includes being responsible for increasing reimbursement success.
  • Gap to be addressed by this activity: Knowledge, Skills, Practice.
Course summary
Available credit: 
  • 2.00 CE Contact Hour(s)
  • 2.00 IBON
Course opens: 
Course expires: 
Event starts: 
02/16/2021 - 12:00pm CST
Event ends: 
02/16/2021 - 2:00pm CST

Mary Ann Hodorowicz, RD, LDN, MBA, CDE, CEC

Ms. Hodorowicz is a professional consultant, educator, speaker, writer and spokesperson for the health and food industry. She is a registered, licensed dietitian, certified diabetes educator and certified endocrinology coder with multiple skills and years of experience in the food, nutrition and diabetes care and healthcare industries. Her clients include both small or large organizations and individuals in private practice.

Ms. Hodorowicz's consulting and training services are designed to provide you with a high level of expertise to achieve your short or long-term goals in a cost-effective and timely manner. Mary Ann's excellent verbal and written communication skills, expertise in project management and a creative spirit all combine to meet your unique needs and goals.

Curriculum Vitae

Accreditation Statements

  • Nurse: Des Moines University is Iowa Board of Nursing approved provider #112. This live activity has been reviewed and approved for 2.0 continuing education contact hour(s). No partial credit awarded.


No commercial interest company provided financial support for this continuing education activity.


Relevant to the content of this educational activity, the following individual(s) have no conflict(s) with commercial interest companies to disclose.

  • Alexandra Grossman, MA, RDN, LD, moderator and planning committee member
  • Laurene Hendricks, activity director and moderator
  • Mary Ann Hodorowicz, RDN, MBA, CDCES, CEC, speaker

The speaker(s) will disclose if any pharmaceuticals or medical procedures and devices discussed are investigational or unapproved for use by the U.S. Food and Drug Administration (FDA). Determination of educational content and the selection of speakers is the responsibility of the activity director. 


The information provided at this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition. The content of each presentation does not necessarily reflect the views of Des Moines University.

Available Credit

  • 2.00 CE Contact Hour(s)
  • 2.00 IBON


Please login or Create an Account to take this course.

There is no cost to attend this webinar but registration is required. 

After you register, you'll receive an email with instructions on how to complete your registration through Zoom.