CMS revises CGM supplies policy

By HME News Staff
Updated 11:51 AM CST, Thu January 23, 2025
WASHINGTON – CMS last week issued a revised policy (CR 13049) to update documentation requirements for replacement supplies of beneficiary-owned CGMs. Effective Feb. 18, 2025, contractors reviewing claims for CGM supplies will no longer need to verify that the original requirements for the CGM receiver were met. Once Medicare has paid for the CGM receiver, medical necessity for the receiver is considered established. A supplier only needs to provide medical necessity documentation for the on-going supplies. This aligns CGM policies with other DME items such as CPAP devices. AAHomecare says the updated policy change will streamline coverage for beneficiaries and considerably reduce the administrative burden for suppliers. The association has been working with the DME MACs and CMS on this issue over the last few months and thanks CMS for recognizing the challenges faced by suppliers and for listening to industry feedback in making this important change.
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