CPT® Code 0403T

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

The CPT® Code 0403T refers to a preventive behavior change program specifically designed for individuals identified as being at risk for developing type 2 diabetes. This program utilizes a standardized diabetes prevention curriculum and is conducted in a group setting. The primary objective of this intensive program is to facilitate behavior modification that can lead to a reduction in the risk of diabetes through lifestyle changes. Participants typically engage in the program for a minimum of 60 minutes each day. The criteria for determining an individual's risk for type 2 diabetes may include factors such as being overweight, with a Body Mass Index (BMI) of 24 or greater (or 22 or greater for individuals of Asian descent), elevated hemoglobin A1C levels ranging from 5.7% to 6.4%, fasting plasma glucose levels between 100 to 125 mg/dL, or results from an oral glucose tolerance test (OGTT) indicating levels from 140 to 199 mg/dL. Additionally, a history of gestational diabetes can also be a significant risk factor. The program emphasizes moderate weight loss through a structured approach that includes a progressive reduction in caloric and fat intake, increased physical activity—aiming for at least 150 minutes of brisk walking per week—and the development of problem-solving and coping skills. A trained lifestyle coach leads the sessions, which may occur weekly to monthly, and encompass education, behavior modification techniques, stress management strategies, and peer support to enhance the participants' ability to make lasting changes in their health behaviors.