2025 CPT code 0403T
(Active) Effective Date: N/A Preventive Medicine - Diabetes Prevention Feed
Preventive behavior change, intensive program of prevention of diabetes using a standardized diabetes prevention program curriculum, provided to individuals in a group setting, minimum 60 minutes, per day.
This code is for patients with prediabetes, identified by abnormal blood glucose levels (impaired glucose tolerance or impaired fasting glucose). Documentation of the patient's diagnosis is essential for medical necessity.
The provider leads a group of patients with impaired glucose tolerance through an intensive program to prevent or delay the onset of diabetes. The program must adhere to a standardized diabetes prevention curriculum and requires a minimum of 60 minutes of provider-led instruction per day.
In simple words: This is a group program that helps people prevent type 2 diabetes. It teaches healthy lifestyle changes like diet and exercise, and how to manage stress. The program lasts at least an hour each day.
This code represents a structured, intensive program for preventing diabetes through behavior modification and lifestyle changes. It is based on a standardized curriculum and delivered in a group setting for at least 60 minutes per day. The program includes components such as nutrition, exercise, stress management, and weight management, typically led by trained lifestyle coaches. It's designed for individuals at high risk of developing type 2 diabetes.
Example 1: A physician conducts a 60-minute group session focusing on healthy eating habits for individuals with prediabetes as part of a recognized diabetes prevention program., A registered dietitian leads a 75-minute group session on portion control and meal planning in a hospital outpatient setting for a diabetes prevention program., A certified diabetes educator leads a 90-minute class at a community center that combines physical activity and stress management techniques for program participants.
Documentation should include the date and time of the service, the total duration of the session (at least 60 minutes), confirmation that the program adheres to a standardized diabetes prevention curriculum (such as the CDC's National DPP curriculum), and a list of participants. Any individualized recommendations or assessments should also be documented.
- Specialties:Endocrinology, Primary Care, Internal Medicine, Family Medicine, Diabetes Education
- Place of Service:Office, Outpatient Hospital, Public Health Clinic, Federally Qualified Health Center, Community Mental Health Center, Other Place of Service