Medicare Diabetes Benefits

Diabetes Monitoring:

• Includes coverage for glucose monitors, test strips, lancets and in certain circumstances, self-management training

• Patient pays 20 percent of the Medicare-approved amount after the yearly Part B deductible

Retinal Eye Examination:

• Includes a comprehensive eye exam with dilation

• Patient pays 20 percent of the Medicare-approved amount after the yearly Part B deductible

A1C Test:

• Totally covered benefit

• Patient is not responsible for a co-pay and there is no deductible requirement

Lipid Profile Test:

• Totally covered benefit

• Patient is not responsible for a co-pay and there is no deductible requirement

The Centers for Medicare & Medicaid Services (CMS) provides national measurement specifications, which provide additional detail on CMS's diabetes indicators and Current Procedural Terminology (CPT) codes. Click here to download. 

To learn more about participating with NMMRA in quality improvement projects on diabetes, contact Patricia Montoya, RN, MPA, quality improvement manager, at (505) 998-9735.