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TO:     All Providers

RE:     Continuous Glucose Monitor Policy Updates

Effective October 1, 2025, Continuous Glucose Monitors (CGMs) will be covered with prior authorization (PA) for recipients (children and adults) with one of the following:

• type 1 diabetes mellitus
• type 2 diabetes mellitus AND are insulin treated with multiple (three or more) daily injections of insulin

NOTE: Please review the full coverage criteria located on the durable medical equipment (DME) webpage at https://medicaid.alabama.gov/content/4.0_Programs/4.3_Pharmacy-DME/4.3.17_CGM.aspx.

An updated checklist will also be available on the DME webpage https://medicaid.alabama.gov/content/4.0_Programs/4.3_Pharmacy-DME/4.3.16_DME_PA_Checklists.aspx.

The Provider Billing Manual will be updated with the new criteria as soon as possible. Policy questions concerning this ALERT should be directed to the DME Program at (334) 242-5050.