March 24, 2021

State of Alabama
Press Release: Medicaid

Durable Medical Equipment (DME) Program Updates Related to Continuous Glucose Monitor (CGM) Update

TO:  DME Providers, Prosthetics & Orthotics (P&O) Providers, Pharmacies, Physicians,
Physician Assistants, Nurse Practitioners

RE:  Durable Medical Equipment (DME) Program Updates Related to Continuous Glucose Monitor (CGM) Update

Effective April 12, 2021, providers dispensing a CGM will need to bill a specific modifier for each brand of CGM. Please see the below table for more information. Providers submitting prior authorizations (PA) on or after date of service April 12, 2021, should include the appropriate modifier on the PA. No changes are being made to the current PA policy or criteria. 

Brand of CGM

Modifier

Dexcom

SC

Freestyle

U6


For more information regarding CGM billing, please refer to Chapter 14 of the Provider Billing Manual at the following link:
https://medicaid.alabama.gov/content/Gated/7.6.1G_Provider_Manuals/7.6.1.1G_Jan2021.aspx.

  

The Current Procedural Terminology (CPT) and Current Dental Terminology (CDT) codes descriptors, and other data are copyright © 2021 American Medical Association and © 2021 American Dental Association (or such other date publication of CPT and CDT). All rights reserved. Applicable FARS/DFARS apply.



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