Diabetes Resupply: Establish infrastructure 

Q. How do HME businesses get started with a CGM resupply program?  

A. Most HME providers already possess the foundational capabilities needed for a CGM resupply program—such as patient outreach, billing expertise and established provider relationships. Success lies in integrating these assets into a scalable, compliant and patient-centered model.  

The first step is to review payer contracts. Continuous glucose monitors may be covered under the medical benefit (via HCPCS codes), the pharmacy benefit (using NDC billing), or both (dual benefit). Reviewing the Medicare LCD helps clarify eligibility and documentation standards. Medicaid and commercial contracts should also be evaluated to identify access and confirm qualification criteria.  

Licensing must be addressed early in the process. Distribution across state lines may require additional DME or pharmacy licensure. A legal review is recommended to ensure compliance with applicable regulations in each state of operation.  

Partnering with a CGM distributor that specializes in diabetes care is essential. The ideal distributor offers onboarding support, manages drop-shipping logistics and provides product education, enabling program expansion without the need for inventory or warehousing.  

Establishing a consistent resupply strategy is essential. Outreach through text messages, emails, phone calls, or patient portals can support timely reorders every 30 to 90 days—driving adherence, improving outcomes and generating recurring revenue. 

Program growth can be supported through internal patient surveys and targeted marketing to individuals with chronic comorbidities, such as those already using respiratory or wound care equipment. Provider relationships may be expanded by presenting CGM services to endocrinology and primary care offices. Manufacturer representatives can also serve as field-level allies in promoting patient access.  

Finally, accreditation should be updated to include diabetes testing supplies. With the right infrastructure and partner network, a CGM resupply program can become a strategic and impactful addition to any HME business. 

Matt Edwards is CEO of GEMCO Medical. Reach him at marketing@gemcorehealth.com.