Medicare Criteria

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 has been testing four or more times a day

  • The beneficiary uses three or more daily injections (MDI) or a 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? Not sure if you qualify? No problem! Let our team of diabetes care experts assist you through the process.


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