What are Current Reimbursement Strategies for Prediabetes Care?
Insurance plans differ in reimbursement for diabetes and prediabetes screening and treatment. Most insurance plans cover testing for people suspected of having diabetes. Becausethe tests and risk factors are the same for both conditions, a prediabetes test may be covered. Medicare As of 2005, the Centers for Medicare and Medicaid Services (CMS) cover screening tests for diabetes for those who have been diagnosed with prediabetes. The CMS policy covers the following: • Two diabetes screening tests per year for individuals with diagnosed prediabetes. • One diabetes screening test per year for individuals who were never tested or whose test results were negative for prediabetes. Covered tests include the fasting blood glucose (FBG) test and the post-glucose challenge test (OGTT). Medicare-covered diabetes screening tests do not require co-payments, deductibles, or coinsurance from the Medicare member.27 Individuals who have any one of the following risk factors for diabetes are eligible f
