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CMS MDPP Billing and Claims Fact Sheet - CMS Innovation

CMS MDPP Billing and Claims Fact Sheet - CMS Innovation 2025

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The document is a comprehensive Network Provider Intake Form used during the initial face-to-face visit with a beneficiary. It collects essential information about the beneficiary, including personal details, mental health history, safety risks, substance use, and functional impairments. The form also outlines a clinical assessment section that evaluates the beneficiary's mental status and psychiatric medication history. Additionally, it includes a Partnership Plan for Wellness that specifies treatment goals, modalities, and strategies to achieve these goals while ensuring necessary consents are documented.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How many times a year will Medicare pay for an A1C test?

Covers certain doctors services, outpatient care, medical supplies, and preventive services. covers up to 2 blood glucose (blood sugar) laboratory test screenings (fasting or non-fasting) each year if your doctor determines youre at risk for developing diabetes.

What is the Mdpp capacity assessment?

MDPP Capacity Assessment Developed with input from experienced MDPP suppliers, this tool is designed to help CDC-recognized organizations assess their capacity and readiness to become an MDPP supplier or to implement the MDPP.

What is G9873?

Participants enrolled in the Medicare Diabetes Prevention Program (MDPP) cannot self-report blood test results; lab results must be provided.

What is the expanded model of Mdpp?

The Medicare Diabetes Prevention Program (MDPP) Expanded Model is a structured behavior change intervention intended to prevent type 2 diabetes in people with prediabetes who have Medicare.

What is MDPP coverage on Medicare?

The MDPP expanded model allows Medicare beneficiaries to access evidence-based diabetes prevention services with the goal of a lower rate of progression to type 2 diabetes, improved health, and reduced spending.