I’m a Medicare patient with diabetes interested in Continuous Glucose Monitoring. How do I know if I’m covered?

Medicare Coverage Criteria:

Therapeutic Continuous Glucose Monitoring (CGM) and related supplies are covered by Medicare when all of the following coverage criteria (1 – 5) are met:

1. The beneficiary has diabetes mellitus; and,
2. The beneficiary is insulin-treated with multiple (three or more) daily administrations of insulin or a continuous subcutaneous insulin infusion (CSII) pump; and,
3. The beneficiary’s insulin treatment regimen requires frequent adjustment by the beneficiary on the basis of BGM or CGM testing results; and,
4. Within six (6) months prior to ordering the CGM the treating practioner has an in-person visit with the beneficiary to evaluate their diabetes control and determined that criteria (1-3) above are met; and,
5. Every six (6) months following the initial prescription of the CGM the treating practioner has an in-person visit with the beneficiary to assess adherence to their CGM regimen and diabetes treatment plan.