CGM = continuous glucose monitoring; DME = durable medical equipment; FFS = fee for service. *Under Medicare’s DME fee schedule, reimbursement and coinsurance for CGMs using CPT codes A4239 and E2103 are the same, regardless of CGM brand. †The local coverage determination expands coverage ...
Deadline Nears for Decision on Medicare CGM CoverageMary K. Caffrey
$0 monthly premium $0 deductible no gap in coverage no gap in coverage $1 co-pay for generics; $3 co-pay for name brands must be Medicaid- eligible $0 monthly premium $0 deductible no gap in coverage $2 co-pay for generics; $5 co-pa...