Claims for Medicare Diabetes Prevention Program services being denied

Jul 06, 2018
The Bottom Line

CMS recently clarified that Medicare Administrative Contractors are rejecting claims for Medicare Diabetes Prevention Program (MDPP) services submitted by organizations and existing Medicare providers that are not enrolled separately as MDPP suppliers. The agency stated that valid claims for MDPP services must be submitted by enrolled MDPP suppliers. Before submitting claims for these services, make sure your organization:

  • Meets all MDPP supplier requirements and standards, including preliminary or full Centers for Disease Control and Prevention recognition
  • Has a separate Medicare enrollment as an MDPP supplier

Providers can visit the MDPP webpage for information on supplier enrollment.

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