What Is a CDCES & How I Can Find One?
Certified Diabetes Care and Education Specialists (CDCES), informally known as “diabetes educators”, can be a critical part of your care team. Here’s a rundown on who CDCESs are, how to find one, and how to get services covered.
What is a Certified Diabetes Care and Education Specialist?
A CDCES is a medical professional who’s obtained a certification after extensive training in diabetes care and education. Most of us are registered dietitians (RDs) or registered nurses (RNs). However, CDCESs can be pharmacists, medical doctors, social workers, and others with advanced degrees in the medical field. Beyond the foundational degree, we are required to log 1,000 hours of direct diabetes education services over two years before sitting for the CDCES exam. Additionally, we complete 15 continuing education hours in diabetes yearly to maintain our certification. In short, seeing “CDCES” after someone’s name means they’ve committed to continued learning about diabetes and the people it affects.
Pro tip: While some medical personnel may put “diabetes educator” in their title, working with someone who is a CDCES is significantly more encompassing. If you’re referred for diabetes education, ask your educator about their background and credentials. (Random fact: I’ve been asked this only a handful of times - yikes!)
Where can I find a CDCES?
Finding a CDCES can be challenging, particularly in rural areas. There are approximately 19, 500 CDCESs in the U.S., or about 1 CDCES to every 1700 people with diabetes.1,2 Most CDCESs can be found within a diabetes education program at a local hospital or a nearby clinic. Diabetes programs are overseen by the American Diabetes Association and/or the Association of Diabetes Care and Education Specialists. This oversight gives standards and structure that must be followed in providing diabetes care and education. Outside of these programs, more and more CDCESs are offering their services online, via virtual visits. To find a diabetes program near you, click here. To find a CDCES in your area, click here.
Do I need a referral?
Yes. Your primary care provider (PCP) will send a referral for “Diabetes Self-Management Training (DSMT)” to the diabetes program nearest you. The referral will specify the services that need to be provided. For example, comprehensive support after a new diagnosis, specialized RD support called Medical Nutrition Therapy (MNT), medication education and/or adjustment, or training on diabetes technologies. If you work with a CDCES online, they may or may not request a referral from your provider.
Does insurance pay?
Generally, yes, insurance covers DSMT (the service a CDCES provides). Medicare pays for 10 hours of DSMT at diagnosis and 2 hours every year after that. Many insurance companies follow suit in coverage, however, some cover only “as medically necessary.” Insurance is most likely to cover services within an accredited diabetes program. Every insurance plan is different, so it is best to check your benefits prior to seeing a CDCES. Outside of DSMT, other services can be billed. For example, MNT or continuous glucose monitor services can be billed instead of, or in addition to, DSMT. Finally, many online CDCESs cannot bill insurance for DSMT unless they are considered a provider under Medicare rules (ex: an RD is, but an RN isn’t) and are working within their licensed area.
Pro tip: The cost of your visit can vary based on where the diabetes program is based. If it is clinic-based, it may only cost you a copay. If it’s hospital-based, you may have to pay towards your deductible. Be sure to ask the program how they bill before you visit. Also, online CDCESs may provide you a superbill, which you can turn into your flex spending account or health savings account for reimbursement.
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