Implantable Continuous Glucose Monitors (I-CGM)
L38617
Medicare covers implantable continuous glucose monitors (I-CGM) for beneficiaries with diabetes mellitus when the treating practitioner documents sufficient training and the device is prescribed per FDA indications; additionally the beneficiary must be insulin-treated or have documented problematic hypoglycemia (recurrent level 2 events or one level 3 event). Short-term use (72 hours to 1 week) of I-CGM is not covered; beneficiaries switching from a previously covered non-implantable CGM may do so only if all I-CGM criteria are met. Continued coverage requires a documented in-person or Medicare-approved telehealth adherence visit every 6 months and records are subject to post-payment audit and review.
"Beneficiary has diabetes mellitus."
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