405 IAC 5-36-1 - DSMT policy; definitions
Authority: IC 12-15-1-10; IC 12-15-21-2; IC 12-15-21-3
Affected: IC 12-15; IC 27-8-14.5-6
Sec. 1.
(a)
Reimbursement is available for diabetes self management training, as defined in
this rule and when provided in accordance with all applicable provisions of
this rule, provider bulletins, provider manuals, and the provider
agreement.
(b) As used in this
rule, "DSMT" means diabetes self management training and is comprised of those
services provided in accordance with IC
27-8-14.5-6. These services are
intended to enable the member to, or enhance the member's ability to, properly
manage the member's diabetic condition, thereby optimizing the member's own
therapeutic regimen. Examples of DSMT include, but are not limited to, the
following:
(1) Instruction regarding the
diabetic disease state, nutrition, exercise, and activity.
(2) Medications counseling.
(3) Blood glucose self-monitoring
training.
(4) Foot, skin, and
dental care.
(5) Behavior change
strategies and risk factor reduction.
(6) Preconception care, pregnancy, and
gestational diabetes.
(7) Accessing
community health care systems and resources.
(c) As used in this rule, "health care
professionals" means the following:
(1)
Chiropractors.
(2)
Dentists.
(3) Health facility
administrators.
(4)
Physicians.
(5) Nurses.
(6) Optometrists.
(7) Pharmacists.
(8) Podiatrists.
(9) Environmental health
specialists.
(10)
Audiologists.
(11) Speech-language
pathologists.
(12)
Psychologists.
(13) Hearing aid
dealers.
(14) Physical
therapists.
(15) Respiratory
therapists.
(16) Occupational
therapists.
(17) Social
workers.
(18) Marriage and family
therapists.
(19) Physician
assistants.
(20) Athletic
trainers.
(21)
Dietitians.
(d) As used
in this rule, a "unit" of DSMT service means a time period of fifteen (15)
minutes.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.