Adjustment to Fraud Prevention System (FPS) and Unified Program Integrity Contractor (UPIC) Edits to Increase Billing Increments From 30 Days to 90 Days for CGM Supplies

Related CR Release Date: October 19, 2023
Effective Date: January 1, 2024
Implementation Date: January 2, 2024
Related Change Request (CR) Number: CR 13397
Related CR Transmittal Number: R12303OTN

CR 13397 instructs Medicare Administrative Contractors (MACs) to make adjustments to their local edits to allow for Continuous Glucose Monitor (CGM) supplies to be billed in 90-day increments to align with the current practices in place for Blood Glucose Monitor (BGM) supplies.

Make sure your billing staff knows about these changes.

View the complete CMS Change Request (CR)13397.

Last Updated Jan 25 , 2024