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 the intended therapeutic/adjunctive use, the treating practitioner documents sufficient beneficiary/caregiver training via prescription, and the beneficiary is either insulin-treated or has documented problematic hypoglycemia (recurrent level 2 events or at least one level 3 event). Continued coverage requires documentation of adherence and the diabetes treatment plan during an in-person or Medicare-approved telehealth visit every six months; short-term diagnostic use (72 hours to 1 week) is not covered. Exceptions permit switching from a Medicare-covered non-implantable CGM with a provider order if all other criteria are met.

"Beneficiary has diabetes mellitus (see LCD-related Policy Article for applicable ICD-10 diagnosis codes)."