Article Detail - JA DME
Continued Coverage for Continuous Glucose Monitor (CGM)
The treating practitioner must conduct, and sign follow up visits for Continuous Glucose Monitor (CGM) continued coverage. As noted in the Glucose Monitors Local Coverage Determination (LCD L33822), for continued CGM coverage, every six (6) months following the initial prescription of the CGM, the treating practitioner must conduct an in-person or Medicare-approved telehealth visit with the beneficiary to document adherence to their CGM regimen and diabetes treatment plan (emphasis added). For Medicare purposes, a pharmacist is not considered a statutorily recognized treating practitioner; therefore, a pharmacist's entry in a beneficiary's medical record does not meet the continued coverage requirements in the Glucose Monitors LCD. Please see the Standard Documentation Requirements Article for a clear definition of who qualifies as a treating practitioner.
