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
  • 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:
  1. Complete online application
  2. Gather and upload supporting documentation
  3. Complete telephone interview
Three steps:
  1. Contact ADA to be set up in the application portal that allows one to enter and save the application unlimited times prior to submitting
  2. Complete the online new service application
  3. 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
  • 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