Diabetes and COVID-19

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Can RN CDCES provide DSMT via telehealth?

  • 1.  Can RN CDCES provide DSMT via telehealth?

    Posted 04-06-2020 17:09
    ​All the information I have accessed has indicated RNs and Pharmacists are unable to bill for DSMT via telehealth.  Is there any recent updates with COIVID-19 indicating RNs can provide DSMT via telehealth?

    Thank you for your input,

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    Angela Frey BSN, RN, CDCES
    Wauseon OH
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  • 2.  RE: Can RN CDCES provide DSMT via telehealth?

    Posted 04-07-2020 14:37
    so far that is correct
    RD, CDE can provide teleheath services--waiting for RN, CDE rule to change - coudl happen soon

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    Joseph Aloi
    WINSTON SALEM NC
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  • 3.  RE: Can RN CDCES provide DSMT via telehealth?

    Posted 04-08-2020 12:52
    How do we keep with the updates. I am the only diabetic educator within a 100 miles. I have just finished my ADA recognition and received full recognition. However, I am still working on all my hours to test for the CDE exam but I don't enough yet. I really need to do Telehealth with these diabetics.

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    Tammy Krell RN, MSN
    SLMC
    Kemmerer WY
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  • 4.  RE: Can RN CDCES provide DSMT via telehealth?

    Posted 04-08-2020 12:57
    I understand Pharmacists are exempted but what if the Pharmacist is a certified Diabetes educator?​

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    Shesha Desai
    RWJ UNIV HOSPITAL HAM
    Hamilton NJ
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  • 5.  RE: Can RN CDCES provide DSMT via telehealth?

    Posted 04-09-2020 13:31
    We need the ADA to vigorously advocate​ CMS (and other payors) for change in that policy - particularly since communication of medication/insulin changes is outside scope of practice for RDs in most states.

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    Catherine Rolih MD
    Novant Health
    WINSTON SALEM NC
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  • 6.  RE: Can RN CDCES provide DSMT via telehealth?

    Posted 04-09-2020 14:08
    I fully agree with you Catherine Rolih, MD. RD are great for the diet part but there is so much more to education for Diabetic patients.

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    Tammy Krell RN, MSN
    SLMC
    Kemmerer WY
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  • 7.  RE: Can RN CDCES provide DSMT via telehealth?

    Posted 04-10-2020 19:52
    The ADCES website posted on their advocacy page a way to send a letter to CMS to petition to allow RNs and Pharmacists to be able to perform telehealth.  Below is the link if you are interested in sending a letter to CMS.

    https://www.diabeteseducator.org/advocacy/adces-legislative-action-center#/

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    Pamela Trohimovich BSN, CDCES
    BELLEVUE WA
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  • 8.  RE: Can RN CDCES provide DSMT via telehealth?

    Posted 04-13-2020 09:28
    Thank You.
    Submitted as suggested​

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    Shesha Desai
    RWJ UNIV HOSPITAL HAM
    Hamilton NJ
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  • 9.  RE: Can RN CDCES provide DSMT via telehealth?

    Posted 04-13-2020 16:21
    The Coding which RND's use to provide Medical Nutrition Therapy to diabetes and renal patients was supported by the National Academy of Nutrition and Dietetics in order to provide RDN'S with reimbursement for seeing Medicare patient for which we previously received no reimbursement!  Naturally, our outpatients became are a good number of diabetic patients. The goal of this was not to just provide payment for diabetes self-management services only. This was never meant to provide payment or to cover all diabetes services, yet people try to high jack these to cover their costs in different situations. The financial support for and lobbying for reimbursement took a long time too!  While many of us cross-train where there is a need for services, for example, I as an RDN  who is board-certified in critical care and in diabetes so I am able to teach all aspects of DMSE.  The designation of CDE does not mean you have a degree in or license to provide Medical Nutrition therapy and in most states, the only person who is licensed to provide Medical Nutrition Therapy is the RDN.  CDE nurses are valuable team members, and they understand the role of nutrition therapy,  but in terms of providing the same level of skill in the provision of Medical Nutrition Therapy their training can be somewhat short.   Medical Nutrition Therapy is not quite as easy using MyPlate as I see when I am teaching nurse providers.  Nurses have one semester of nutrition.  Most of us RDN's have Masters Degrees in the field.  The documentation and billing should reflect the type of technical care provided. What is needed is legislation by nurses to request coded to do what they do best too.  That way patients have the opportunity to get more time with both specialties.  Time with the RN and Time with the RDN.  Keep plugging away at it  RNs don't need to sell Medical Nutrition Therapy short.  By high jacking these little reimbursement codes you are selling our patients short.  Keep asking for reimbursement for the skills you offer so we all can meet the standards of care for our patients.

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    Dana Thompson MSC, CDE
    Advantage Nutrition and Diabetes Prevent
    Glendale AZ
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