Continuous Glucose Monitor Medical Policy

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Continuous Glucose Monitors

https://www.fepblue.org/benefit-plans/medical-policies-and-utilization-management-guidelines/-/media/PDFs/Medical%20Policies/07-10-2020/5_99_14%20Continuous%20Glucose%20Monitors.pdf

This policy statement applies to clinical review performed for pre-service (Prior Approval, Precertification, Advanced Benefit Determination, etc.) and/or post-service claims. Continuous glucose monitors may be considered medically necessary for …

New Medicare Coverage Requirements Make CGMs …

https://diabetes.org/tools-support/devices-technology/cgm-medicare-coverage-requirement-change-accessibility

Beginning on July 18, 2021, Medicare will permanently eliminate the requirement of the four-time-daily fingerstick in order to qualify for coverage of a continuous glucose monitor …

Continuous Glucose Monitoring and Insulin Delivery …

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-medical-drug/continuous-glucose-monitoring-insulin-delivery-managing-diabetes.pdf

Continuous Glucose Monitoring (CGM) Note: Coverage criteria noted below must be met whether the request comes through the UnitedHealthcare prior authorization process …

CG-DME-42 Continuous Glucose Monitoring Devices …

https://www.anthem.com/dam/medpolicies/abc/active/guidelines/gl_pw_d073854.html

Clinical UM Guideline Description This document addresses the use of continuous glucose monitoring devices (CGMs, also referred to as continuous …

Last Review Status/Date - FEP Blue

https://www.fepblue.org/-/media/PDFs/Medical%20Policies/11-16-2021/Pharma%20Policies%20Replace/5_99_14%20Continuous%20Glucose%20Monitors.pdf

This policy statement applies to clinical review performed for pre-service (Prior Approval, Precertification, Advanced Benefit Determination, etc.) and/or post-service claims. …

Clinical Policy: Continuous Glucose Monitors

https://www.healthnet.com/content/dam/centene/healthnet/pdfs/provider/ca/policies/7809.pdf

Continuous glucose monitors are indicated for use in patients with diabetes mellitus to monitor blood glucose levels. Policy/Criteria Provider must submit documentation …

Continuous Glucose Monitoring Systems | BCBSND

https://www.bcbsnd.com/providers/policies-precertification/medical-policy/c/continuous-glucose-monitoring-systems

Description. Continuous Glucose Monitoring (CGM) Systems (also known as Real-Time or interstitial) monitor, measure, and record glucose levels in interstitial …

Continuous Glucose Monitors - UHCprovider.com

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/medadv-guidelines/c/continuous-glucose-monitors.pdf

Implantable continuous glucose monitors (I-CGMs) are class III medical devices that require premarket approval by the FDA (e.g., Eversense). The FDA recently approved …

Continuous Glucose Monitor policy changes could close equity gaps

https://medschool-test.healthsciences.ucla.edu/news/continuous-glucose-monitor-policy-changes-could-close-equity-gaps

Continuous Glucose Monitor policy changes could close equity gaps. UCLA Health resident aims to serve under-resourced patients. Current estimates from the Centers for …

PRIOR AUTHORIZATION POLICY

https://d11tr245s7jfj6.cloudfront.net/2023-01/Diabetes%20-%20Continuous%20Glucose%20Monitoring%20Systems%20PA%20Policy.pdf

Coverage of the continuous glucose monitoring systems in this policy is recommended in those who meet the following criteria: FDA-Approved Indication 1. Diabetes. ...

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