top of page
Preston Cranford

How can implementing DSME services help your pharmacy?

Updated: Feb 23

As a pharmacy owner, what are the most important aspects of ensuring your pharmacy is successful? It may be presumptuous, but our guess would include increasing revenue and helping your community to stay healthy. Independent pharmacies are special precisely because they have a focus on community. Miss Judy comes in a couple times per month, and lives just down the street–and you know her. What’s more, you care about her health. She’s one of the 93% of Americans with diabetes who doesn’t participate in any diabetic self-management education courses. She also always has those candies that taste like and are wrapped to look like strawberries (where does she even get those??). She shares them with the staff, too.


Through clinical services billing, you can combine both of these goals. You can help Miss Judy and expand your clinical footprint within the patient pool that you already have. Pharmacies can offer the diabetic self-management education that so many in the United States need. Many people with diabetes don’t understand how to properly handle their condition, and education helps immensely–DSME has shown to lower A1c levels by 1%, and has a host of other benefits. Things like improving quality of life, creating better lifestyle patterns, even reducing depression. (For everything else, there’s mastercard, you get it.) Now, accredited pharmacists can also receive reimbursement for it–even from commercial and private payers. First, you’ll need to be accredited.


What is DSME accreditation? Why is it required? And how will it help pharmacies expand?


To provide DSME-services you must be DSME-accredited which can be a lengthy and difficult process that not many know how to navigate (which is DSME-frustrating as hell). This leaves pharmacists in the dark, but there’s light at the end of the tunnel! Provider CSAO’s Dr. Angelina Tucker has extensive experience guiding pharmacies through this journey, and (fortunately for literally everyone) is passionate about expanding this clinical service. As such, she will personally guide pharmacists through the process in the effort to grow clinical pharmacy and benefit the 36 million Americans who are either not enrolled or do not have access to diabetic education.


Being accredited to provide DSME will benefit you in many ways, including:

  • The ability to bill for DSMT/DSME through Medicare, some state Medicaid agencies, and private insurers

  • Improved care and health status reporting

  • Alignment with quality improvement and population health goals

  • Access to ADCES or ADA resources and support

Let’s also talk about how to ensure pharmacies are reimbursed for this service. Provider will coordinate your credentialing so that you are in network with commercial payers. Reimbursement rates can vary from payer to payer and state to state (reach out for more info), but Medicare reimbursements look like this:

  • DSME cpt code for individual 1 on 1 session - 1 hr G0108 - $120

  • DSME cpt code for group session (2 or more) G0109 - $28 per patient per hour


We’ll provide an array of times for our consultations guiding you through the accreditation process. These consultations will be broken up into 15, 30, or 60 minute time segments based on the needs of the pharmacy. We can fit with your journey.


You already have the patient population to offer these services. They’re filling at your pharmacy every day. By earning the accreditation, you’re greatly increasing your revenue opportunities without the need of increasing patient population. It’s value added for the same patients you already serve. And that’s pretty sweet.


If you’re struggling to finish your accreditation or considering beginning the process, reach out to us and let us help you through it. And then, you go help Miss Judy.



Recent Posts

See All

Comments


bottom of page