Boost Members' Health - Lower Diabetes-Related Costs | Recording-Boost Members' Health

Video Transcription

Video Summary

The Diabetes is Primary October 2025 webinar emphasized integrating Certified Diabetes Care and Education Specialists (CDCES) into primary care to enhance diabetes management. Moderated by Paige Johnson, the session featured panelists Bobbi Harmon, Carrie Keyes, and Dr. David Shelburne, who highlighted CDCES roles, CGM (Continuous Glucose Monitoring) technology, and billing practices.<br /><br />Bobbi explained that CDCES are healthcare professionals with specialized diabetes expertise, offering self-management education, behavioral support, and technology integration in primary care. Their involvement helps improve patient outcomes, provider experience, and lowers healthcare costs. CDCES facilitate referrals for diabetes self-management education and support (DSMES), overcoming Medicare complexities and tailoring ongoing education to patient needs.<br /><br />Carrie detailed CGM billing, focusing on CPT code 95251 for professional CGM data interpretation. This billing, available to physicians, PAs, and NPs, requires documentation of at least 72 hours of CGM data and appropriate diagnosis. Three billing scenarios were outlined: during a clinician's visit, alongside another provider's encounter, and remote patient monitoring. She stressed that proper CGM billing can generate significant work RVUs, adding substantial revenue and supporting sustainable practice models.<br /><br />Dr. Shelburne shared practical experiences implementing CDCES and CGM in primary care, emphasizing improved patient outcomes, clinician confidence, and onsite diabetes education. He highlighted workflow integration, teamwork, and financial sustainability through ADA-accredited multi-site programs. A case study illustrated dramatic patient improvement after CDCES involvement.<br /><br />The panel discussed challenges in device provision, provider time constraints, and the importance of streamlining workflows to facilitate CGM use and billing. The collaborative model of primary care involving CDCES was presented as essential to meet growing diabetes demands with effective, patient-centered, cost-efficient care. The session concluded with resources for further education and a call to adopt these approaches broadly.

Keywords

Diabetes management

Certified Diabetes Care and Education Specialists

CDCES

Primary care integration

Continuous Glucose Monitoring

CGM billing

CPT code 95251

Diabetes self-management education

DSMES

Healthcare cost reduction

Patient-centered care