Delivering a Lifestyle Change for Medicare Beneficiaries

Providers play a vital role in beneficiary referrals. Although a referral is not required, a provider’s assessment during the AWV or the IPPE is strongly recommended by NGS. Providers may also help Medicare patients obtain the blood tests they need to become aware of their risk and recommend they participate in MDPP services.

Hundreds of lifestyle change programs nationwide teach participants to make lasting lifestyle changes, like eating healthier, adding physical activity into their daily routine and improving coping skills.

Research studies have consistently shown that interventions such as the Medicare Diabetes Prevention Program lifestyle changes improve health outcomes and are cost-effective.

CDC-approved curricula can be downloaded from their Curricula and Handouts web page.

Your organization must use an approved curriculum that meets the CDC requirements for recognition. Newly developed curricula must be submitted, reviewed and approved by CDC prior to use. Learn about curriculum requirements and download CDC's National DPP PreventT2 Curricula and Handouts. 

Organizations that wish to furnish MDPP services to beneficiaries and bill Medicare for those services must enroll in Medicare as an MDPP supplier. To enroll as an MDPP supplier, organizations must:

• have MDPP preliminary recognition or full CDC DPRP recognition,
• have an active and valid TIN or NPI,
• pass enrollment screening at the high categorical risk level,
• submit a list of MDPP coaches who will lead sessions, including full name, date of birth, SSN, active and valid NPI and coach eligibility end date (if applicable) on the MDPP enrollment application,
• meet MDPP supplier standards and requirements, and other requirements of existing Medicare providers or suppliers,
• revalidate its enrollment every five years.

Reviewed 9/19/2024