Medicare Diabetes Prevention Program (MDPP) Expanded Model: Supplier Resources

Spotlight
Through the CY 2026 Physician Fee Schedule (PFS) Proposed Rule, CMS proposed several changes to the MDPP expanded model which are aimed toward increasing uptake of and access to this important prevention-focused program, empowering beneficiaries, and promoting further alignment between MDPP and the CDC DPRP Standards. CMS seeks comment on the following proposals to: Update weight collection requirements to allow beneficiaries to self-report weight for MDPP sessions from home or a reasonable location outside of an in-person delivery site (e.g., fitness centers, medical facilities, and temporary abodes) and also allow for the submission of weight collected as part of a medical record, dated within two days of a scheduled MDPP session, to reduce burden, promote safety, and increase access. Extend the flexibilities allowed during the PHE for COVID-19 through December 31, 2029, including the option for MDPP suppliers to deliver some or all MDPP sessions via distance learning and for beneficiaries to virtually self-report weight for MDPP distance learning sessions. Test the additional coverage of asynchronous, online delivery of MDPP through December 31, A2029, in hopes of further increasing program participation among suppliers and beneficiaries and promoting alignment between MDPP and CDC’s DPRP Standards. CMS recommends adding the online delivery modality through December 31, 2029, to test if evaluation results, including weight loss, are similar to in-person and distance learning delivery modalities. Clarify that MDPP suppliers are not required to maintain in-person delivery capability through December 31, 2029, to facilitate the ability of MDPP suppliers to deliver the program asynchronously. This will allow for virtual-only organizations to enroll in Medicare as an MDPP supplier and streamline the process to allow for greater asynchronous delivery. If finalized, these proposed changes will go into effect on January 1, 2026.

Spotlight

Through the CY 2026 Physician Fee Schedule (PFS) Proposed Rule, CMS proposed several changes to the MDPP expanded model which are aimed toward increasing uptake of and access to this important prevention-focused program, empowering beneficiaries, and promoting further alignment between MDPP and the CDC DPRP Standards. CMS seeks comment on the following proposals to:

Update weight collection requirements to allow beneficiaries to self-report weight for MDPP sessions from home or a reasonable location outside of an in-person delivery site (e.g., fitness centers, medical facilities, and temporary abodes) and also allow for the submission of weight collected as part of a medical record, dated within two days of a scheduled MDPP session, to reduce burden, promote safety, and increase access.
Extend the flexibilities allowed during the PHE for COVID-19 through December 31, 2029, including the option for MDPP suppliers to deliver some or all MDPP sessions via distance learning and for beneficiaries to virtually self-report weight for MDPP distance learning sessions.
Test the additional coverage of asynchronous, online delivery of MDPP through December 31, A2029, in hopes of further increasing program participation among suppliers and beneficiaries and promoting alignment between MDPP and CDC’s DPRP Standards. CMS recommends adding the online delivery modality through December 31, 2029, to test if evaluation results, including weight loss, are similar to in-person and distance learning delivery modalities.
Clarify that MDPP suppliers are not required to maintain in-person delivery capability through December 31, 2029, to facilitate the ability of MDPP suppliers to deliver the program asynchronously. This will allow for virtual-only organizations to enroll in Medicare as an MDPP supplier and streamline the process to allow for greater asynchronous delivery.

If finalized, these proposed changes will go into effect on January 1, 2026.

Frequently Asked Questions

The MDPP Supplier Frequently Asked Questions Page provides a list of common questions and answers the CMS has received about the Medicare Diabetes Prevention Program (MDPP). The questions are grouped by topic: Recognition and enrolling in Medicare; Billing and Claims; MDPP Set of Services, and beneficiary eligibility; coach requirements and supplier standards; and Medicare Advantage. Information About Additional Resources is also included on this page.

The 2025 MDPPP Business Case for Prospective Suppliers (PDF) covers a variety of subjects from a high-level overview of MDPP to the expected costs and revenue for delivering MDPP.

MDPP Medicare Enrollment and CDC Recognition

Medicare Enrollment

CDC Recognition and Eligibility

Billing and Payment (for previous resources, visit the MDPP Archive Page)

For CY 2025:

MDPP CDC Crosswalk and Data

Coverage

Medicare Diabetes Screening Changes - AMA Update
Medicare Preventive Screening & Services
Medicare and You (CMS Official Beneficiary Guide to Medicare)
Verifying Beneficiary Eligibility under Original Medicare (PDF)

Medicare Advantage

Supplier Technical Assistance

MDPP Supplier Support Center

The MDPP Supplier Support Center provides responses to MDPP policy-related questions from supplier organizations, stakeholders and the general public. To submit a query to the MDPP model team on MDPP policy, please select “Start New Inquiry” to fill the Inquiry Request form. To track existing inquiries, insert your inquiry tracking number to review the status.

To submit a query to the MDPP model team on MDPP policy, please select “Start New Inquiry” to fill the Inquiry Request form. To track existing inquiries, insert your inquiry tracking number to review the status.

Other Sources for MDPP Help

For questions related to completing the MDPP enrollment application, please call the PECOS Help Desk at 1-866-484-8049.

For assistance with Original Medicare billing and claims or to check the status of your enrollment application, please contact your Medicare Administrative Contractor (MAC).

For beneficiary related inquiries or information about MDPP services, please call 1-800-MEDICARE or visit https://www.medicare.gov/coverage/diabetes-screenings.html.

Have questions about CDC Recognition? Visit the National Diabetes Prevention Program Customer Service Center.