Medicare Criteria for Therapeutic CGMs

According to the U.S. Centers for Medicare & Medicaid Services (CMS), if you have Type 1 or Type 2 diabetes, intensively manage your insulin, and meet all of the following eligibility criteria, you can get a Therapeutic CGM covered by Medicare.

medicare checklist - EHCS

Medicare Criteria for Therapeutic CGMs*

  • The beneficiary has diabetes mellitus
  • The beneficiary administers insulin three or more times per day via MDI or inhalation or uses an insulin pump
  • The treatment regimen requires the beneficiary to frequently adjust based on the therapeutic CGM testing results
  • The beneficiary has seen his/her doctor in the last six months

To remain eligible, the beneficiary must see his/her doctor every six months to evaluate the CGM therapy.

Do you qualify? Apply for your CGM Today! Not sure if you qualify, no problem — let our team of diabetes care experts assist you through the process.

as of July 18, 2021

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