November 3, 2016

Effective Dec. 15, 2016, the Department of Medical Assistance Services (DMAS) will clarify that its coverage of Continuous Glucose Monitoring (CGM) for patients with Type 1 and 2 diabetes as well as gestational diabetes includes reimbursement for the sensor, transmitter, and receiver used with the invasive monitor. This equipment will be supplied by a Medicaid Durable Medical Equipment (DME) provider and billed as a DME item. Codes to be billed for the DME equipment are: 

  1. A9276 (CGM Sensor, invasive), 
  2. A9277 (CGM Transmitter; external) and 
  3. A9278 (CGM Receiver (monitor); external

The CGM equipment requires service authorization. A Certificate of Medical Necessity is required. Providers will fax their requests to DMAS Medical Support Unit at 804 | 452-5450. Click here for additional information.
 

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