Requirements
The Centers for Medicare & Medicaid Services (CMS) has authorized ADCES and ADA to grant accreditation and recognition, respectively, to DSMES service providers. Both require the following:
- Formal application process
- Supporting documentation
- Fee with application
- Annual reports and renewals
- Audit of existing services to ensure compliance with requirements
Program acronyms:
- DEAP: Diabetes Education Accreditation Program (ADCES)
- ERP: Education Recognition Program (ADA)
Benefits
Benefits of being an accredited or recognized provider include:
- DSMT* billing through Medicare, private insurers, and some state Medicaid agencies
- Improved care and health status reporting
- Alignment with quality improvement and population health goals
- Access to ADCES or ADA resources and support
*CMS uses the term "training" (DSMT) instead of "education and support" (DSMES) when defining the reimbursable benefit. This term relates specifically to Medicare billing.
Compare accreditation and recognition processes
Cost
| ADCES Accreditation Process |
ADA Recognition Process |
- 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
| ADCES Accreditation Process |
ADA Recognition Process |
- 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
| ADCES Accreditation Process |
ADA Recognition 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/recognition lasts for 4 years)
| ADCES Accreditation Process |
ADA Recognition Process |
- 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
| ADCES Accreditation Process |
ADA Recognition Process |
- 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
| ADCES Accreditation Process |
ADA Recognition Process |
- 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
| ADCES Accreditation Process |
ADA Recognition Process |
- 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
|
