It’s finally here!!! Type 1 and Type 2 diabetes patients covered by Medicare who are on intensive insulin therapy may now get reimbursed for their Dexcom G5 CGM!
Dexcom’s G5 Mobile system is the only CGM classified as “therapeutic.” A therapeutic CGM is used to inform treatment decisions. Most CGMs are FDA-approved as adjunctive devices, meaning the information they provide is to be used alongside data from other devices, such as blood glucose monitors.
The CMS criteria are that the patient must
- have diabetes
- use a home blood glucose monitor to test for glucose levels frequently
- be treated with multiple daily injections of insulin or with an insulin pump, and
- need to frequently adjust his or her insulin therapy based on data from a therapeutic CGM
“This is a new era and a huge win for people with diabetes on Medicare who can benefit from therapeutic CGM,” said Dexcom CEO Kevin Sayer in a statement. “This decision supports the emerging consensus that CGM is the standard of care for any patient on intensive insulin therapy, regardless of age.”
This is CAUSE FOR CELEBRATION!!!
Read more: Medicare unveils coverage criteria for Dexcom G5 continuous glucose monitor
FANTASTIC news! Thank you for the update on Medicare’s coverage of CGM. It’s such a life saver for people with T1D, as well as the best way to reduce/eliminate long term complications.
Thanks Sandra … just put my order in on Friday. Another reader got his order quickly. It’s good news finally!
It is great cause for celebration. Let’s hope that the new sensor from Medtronic will also qualify. It obviously is used for treatment decisions since it effectively will run the pump. It’s good to be alive.
Yes, Rick, here’s to hoping the G6 will be covered. If not, I’m ready to fight it again!