CMS expands Medicare coverage for all types of CGMs, including adjunctive and non-adjunctive

December 27, 2021 – CMS issued a final rule expanding Medicare access to certain durable medical equipment, such as glucose monitors that increase diabetes treatment choices. The final rule establishes methodologies for adjusting the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) fee schedule amounts and procedures for making benefit category and payment determinations for new items and services that are DMEPOS, therapeutic shoes and inserts, surgical dressings, or splints, casts, and other devices used for reductions of fractures and dislocations under Medicare Part B in an effort to prevent delays in coverage of such items and services.

The final rule also classifies adjunctive continuous glucose monitors (CGMs) as durable medical equipment (DME) under Medicare Part B and finalizes certain DME payment provisions that were included in two interim final rules.

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