Implantable Continuous Glucose Monitors (I-CGM)

Medicare covers implantable continuous glucose monitors (I-CGM) for beneficiaries with diabetes mellitus when the device is FDA-approved for therapeutic use, the treating practitioner documents sufficient beneficiary (or caregiver) training via a prescription, and the beneficiary is either insulin-treated or has documented problematic hypoglycemia. Coverage requires initial documentation and ongoing adherence visits every six months; I-CGMs are not covered for short-term (72 hours to 1 week) diagnostic use. Beneficiaries who previously met coverage for a non-implantable therapeutic CGM may switch to an implantable device with a provider order but must meet all policy criteria.

"Beneficiary has diabetes mellitus (see LCD-related Policy Article ICD-10 code list for applicable diagnoses)."

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