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Administration for Community Living 

Tip Sheet 

The CMS Recognition Process for DSMT Programs 

Purpose: 

The Centers for Medicare & Medicaid Services (CMS) requires all accredited 

diabetes self-management training (DSMT) programs to be formally recognized 

before a provider can submit a claim for reimbursement for delivering that program 

to a Medicare beneficiary. 

This Tip Sheet provides guidance on how to submit proof of accreditation in order 

to become a CMS “Recognized” DSMT provider. 

Background: 

Medicare provides a ten (10) hour DSMT benefit for any beneficiary with a diagnosis 

of diabetes. Providers that wish to receive Medicare reimbursement for providing 

DSMT must first obtain accreditation from one of the two CMS approved National 

Accrediting Organizations – the American Association of Diabetes Educators or the 

American Diabetes Association. 

However, achieving successful accreditation is necessary, but not sufficient. 

The provider must submit proof of accreditation completion to the appropriate CMS 

Part A/B Medicare Administrative Contractor (MAC)1 in order to be a CMS 

Recognized DSMT provider. The proof of successful completion of accreditation is a 

copy of an Accreditation Certificate. It is important to note that the Accreditation 

Certificate must include the name of the current Medicare provider and can include 

the name(s) of any partner organization or community-based organization that is 

supporting the delivery of DSMT with the Medicare provider. 

On the next page we describe the procedure for submitting your proof of 

accreditation to a MAC. 1

 

1 Claims for Medicare reimbursement are not submitted to CMS. Starting with Medicare’s inception 

in 1965, private health care insurers known as Part A Fiscal Intermediaries (FI) and Part B carriers 

have processed medical claims for Medicare beneficiaries. Section 911 of the Medicare Prescription 

Drug Improvement and Modernization Act (MMA) of 2003 mandated that the Secretary of the 

Department of Health and Human Services replace Part A FIs and Part B carriers with Medicare 

Administrative Contractors (MACs). Contracting reform was intended to improve Medicare’s 

administrative services to beneficiaries and health care providers through the use of new contracting 

tools including competition and performance incentives. 

CMS selects MACs in accordance with the Federal Acquisition Regulation. As required under the 

MMA, CMS established MACs as multi-state, regional contractors responsible for administering both 

Medicare Part A and Medicare Part B claims. The transition from the Part A FIs and Part B carriers to 

MACs began in 2006, and the last FI and carrier contracts ended in September 2013. CMS relies on a 

network of MACs to process Medicare claims, and MACs serve as the primary operational contact 

between the Medicare Fee-For-Service program and Medicare providers. 
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Administration for Community Living 

Procedure: 

1. First, access the CMS website dedicated to providing a Directory of CMS 

MACs: 

http://www.cms.gov/Research-Statistics-Data-and-Systems/MonitoringPrograms/Medicare-FFS-Compliance-Programs/Review-Contractor-DirectoryInteractive-Map/

The following screenshot shows the CMS webpage that is accessed using the 

weblink above: 

2. Once at the webpage, you will see a listing of all of the MACs for each state 

and territory. Each state and territory can have a different MAC so it is 

important to determine the MAC that is currently contracted with CMS to 

provide services to your particular state or territory. (Please note that the 

 
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Administration for Community Living 

MACs are all federal contractors with a term-limited contract with CMS to 

provide this function. Therefore, the organization that is contracted with 

CMS to cover your particular state or territory is subject to change. The CMS 

website should provide the most current listing of MACs.) 

3. In order to determine the MAC for your state or territory, select your 

location, using the dropdown menu. 

The following screenshot shows the CMS webpage with the state/territory 

dropdown menu: 

4. After you select the desired state/territory, you will get a listing of current 

MACs. There may be multiple MACs per state for each Medicare coverage 

benefit (i.e., Part A/B, Part D, Durable Medical Equipment, etc.). The DSMT 

benefit is a Medicare Part B benefit. Therefore be sure you select the 
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Administration for Community Living 

organization that is serving as the “Medicare Part A/B Medicare 

Administrative Contractor”.

Example (see the below screenshot): 

State: North Carolina 

MAC: Palmetto GBA Columbia 

Website: http://www.palmettogba.com/medicare

6. Once you have selected the appropriate MAC for your area and benefit, you 

will see a link to that MAC’s website and a phone number. 

7. Click on the web link for the MAC’s website to obtain the correct contact 

information and address. 
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Administration for Community Living

8. By courier or other receipt-provided delivery service (e.g., FedEx, USPS, UPS, 

etc.), submit a hard copy of your current Accreditation Certificate to the MAC, 

along with a cover letter explaining that the listed Medicare Provider 

(including any listed partners/CBOs) is seeking “CMS Recognition as a DSMT 

Provider” subsequent to successful completion of accreditation by one of the 

CMS approved National Accrediting Organizations.

9. Track the submission of your accreditation certificate to the MAC to verify its 

receipt of your materials.

10. Contact the MAC to verify that the Medicare Provider has been added to the 

list of accredited/recognized DSMT programs.

Usually MACs add the providers to the list within two weeks from receipt of 

the documents. However, recognition is retroactive to the date of receipt, 

even if there is a delay in processing at the MAC.

11. If your organization and/or Medicare Provider partner has more than one 

accredited/recognized program, each individual accredited program must 

separately submit its proof of accreditation to the appropriate MAC.

12. Once you know that the MAC received your certificate, you can begin 

providing DSMT services to Medicare beneficiaries and submit claims for 

reimbursement from Medicare using the standard billing and collections 

process approved by CMS.