Attaining reimbursement for diabetes self-management training can be daunting. To some it may be enough to frighten them off. But for the strong of heart you should consider the options that are available to you. Billing for services directly to the patient as a fee for service is one option. Others undertake meeting the requirements as mandated by the Centers for Medicare and Medicaid Services. Presently, there are only a total of 2921 education sites in the United States recognized by the American Diabetes Association’s Education Recognition Program. Understanding the requirements is critical to developing programs for the unmet needs of the 19.2 million patients with diabetes.