Continuous Glucose Monitor (CGM) Billing Reminders
When billing for CGM supply, claims must follow state guidelines and allowable unit limits. Claims should not exceed the authorized allowance to prevent future overpayments, denials, or recoupments.
Billing Therapeutic CGM Supplies with code A4239 represents a monthly supply allowance for therapeutic continuous glucose monitoring systems. One billing unit is equivalent to a one-month supply, and includes all necessary supplies and accessories.
The following HCPCS codes are included in the A4239 allowance and should not be billed separately:
- A4233, A4234, A4236
- A4244, A4245, A4246, A4247
- A4250, A4253, A4255, A4256, A4257, A4258, A4259
- E0607, E2100, E2101
Claims submitted with these codes in addition to A4239 may deny as inclusive services.
Please see MDHHS Policy Bulletin MMP 23-31 for the latest state policy on Medicaid CGM billing.