DSMES Accreditation and Recognition Process

Rubber Stamp. Accredidation and Recognition

The Centers for Medicare & Medicaid Services (CMS) has authorized the Association of Diabetes Care & Education Specialists (ADCES) and the American Diabetes Association (ADA) to grant accreditation (ADCES) or recognition (ADA).

Both ADCES and ADA have a formal application process, require supporting documentation, and require a fee with applications. ADCES and ADA also require annual reports and renewals and audit existing programs to ensure continued conformance with accreditation or recognition criteria. Each program is identified by its acronym: “DEAP” for Diabetes Education Accreditation Program (ADCES) and “ERP” for Education Recognition Program (ADA).

Being an accredited or recognized service benefits DSMES providers in many ways, including:

The ability to bill for DSMT (see note below) through Medicare, some state Medicaid agencies, and many private insurers.
Improved care and health status reporting.
Alignment with quality improvement and population health goals.
Access to ADCES or ADA resources and support.

Note: CMS uses the term “training” (DSMT) instead of “education and support” (DSMES) when defining the reimbursable benefit. This term relates specifically to Medicare billing.

For more information, see Comparing the Processes: Accreditation and Recognition.

Comparison of ADCES and ADA Accreditation/Recognition Processes

Comparison of ADCES and ADA Accreditation/Recognition Processes
	ADCES Accreditation Process	ADA Recognition Process
Cost	First site: $1,100 Additional branch locations: $100 each Each additional community site is free Same fee structure for re-accreditation (accreditation lasts for 4 years)	First site: $1,100 Additional multi-sites: $100 each Unlimited number of expansion sites: no fee Same fee structure for renewal (recognition lasts for 4 years)
Initial Application	Online application Supporting documentation required Application fee is required	Online application for all application types Supporting documentation must be submitted within 2 weeks
Initial Application Process	Three steps: Complete online application Gather and upload supporting documentation Complete telephone interview	Three steps: Contact ADA to be set up in the application portal that allows one to enter and save the application unlimited times prior to submitting Complete the online new service application Submit supporting documentation Recommended but not required: New applicants may attend one of the free New Quality Coordinator or Application Question (Q) and Answer (A) Calls by registering at: http://www.diabetes.org/erpqa
Renewal Application (initial accreditation lasts for 4 years)	Gather supporting documentation: De-identified chart Stakeholder Input minutes CQI project results and plan Submit Annual Status Report Submit online re-accreditation application Pay the re-accreditation fee	Complete the online renewal application Submit the supporting documentation
Timeline for Accreditation/Recognition Process Completion	At least one patient has completed the program through follow-up, and documentation for that patient is submitted (this needs to happen before a program applies for accreditation) Once started, the application must be completed within 90 days Application process: 4-6 weeks Must collect at least one clinical and one behavioral outcome measure Be prepared to submit an Annual Status Report 30 days before and up to 30 days after accreditation anniversary date annually Accreditation valid for 4 years	At least one DSMES participant must complete the initial comprehensive DSMES cycle The application reporting period can be 1 month and up to 6 months prior to application submission The application must be submitted no more than 3 months after the reporting period ends Applications are reviewed on a first-come, first-served basis; this process can take up to 30 days At least two outcomes must be tracked for service effectiveness: Participant-defined goals and measure of goal attainment Other outcome (metabolic, clinical, quality of life) with measure of attainment Annual status report required Recognition valid for 4 years
Support Services	Email, toll-free telephone support ADCES7 online patient education system Free member benefits, including myADCES network, webinars, online discussion groups, free continuing education Online tools and sample documents, monthly DEAP webinars Conferences, online courses, webinars, ADCES curriculum Information on accredited programs listed on website Career network Journals and newsletters One-year complimentary ADCES membership for newly accredited and re-accredited programs	Email, toll-free telephone number #1 Resource: ERP Quality Coordinator Guide Chronicle Diabetes Education Documentation System Education Recognition Program (ERP) Monthly Q and A and Networking Calls Online toolkits, sample templates, and resources ADA publications at a 40% discount Free online patient education materials Free Living Well with Diabetes participant booklets Scientific sessions, conferences Free continuing education opportunities Free webcasts and podcasts Recognized DSMES services Zip Code search, including Pediatric, Spanish, and Long-Distance Learning criteria search ability DSMES service referrals from the ADA Call Center
Audits	On-site audit rate of 5% with a minimum of 44 on-site audits per year and up to a maximum of 70 on-site audits per year. Volunteer auditors 2 weeks’ notice	On-site audit rate of 5% with a cap of 70 per year Volunteer auditors 2 weeks’ notice