Reminder: Follow MDHHS billing guidelines for our Diabetes Prevention Program for Medicaid members
As a reminder, providers participating in our Diabetes Prevention Program (DPP) should follow billing criteria established by the Michigan Department of Health and Human Services (MDHHS) for our Medicaid members.
About DPP
DPP is an evidence-based lifestyle change program recognized by the Centers for Disease Control and Prevention (CDC). The program applies to adults over the age of 18 with prediabetes or at risk to develop type 2 diabetes. Commercial, Medicaid and Medicare members who meet eligibility criteria can participate in DPP once per lifetime.
Why are we issuing this reminder?
We’ll soon implement a clinical edit for DPP diagnosis criteria for Medicaid members. As outlined by MDHHS policy, a diagnosis of Z71.89 - Other Specified Counseling will be required.
What else do you need to know?
You can reference the following for more information and to support accurate billing:
- MDHHS bulletin MMP 23-33 for Medicaid-specific DPP requirements, including diagnosis criteria
- Our Provider Manual for additional information on DPP billing, provider responsibilities, how to become a contracted DPP provider with us and more