Insulin and Non-insulin Dependent Billing Requirements

The KX or KS modifier must be added to blood glucose and continuous glucose monitors as well as related supplies, depending on whether the beneficiary is being treated with insulin. If the beneficiary is being treated with insulin injections, the KX modifier must be added to the code for the monitor and each related supply on every claim submitted to Medicare. If the beneficiary is not being treated with insulin injections, the KS modifier must be used. Noridian's Medical Review and Redeterminations staff are seeing frequent billing errors due to the incorrect use of these modifiers. For proper payment, the correct modifier must to be submitted on each claim.

  • KS Modifier - Glucose monitor supply for diabetic beneficiary not treated with insulin
  • KX Modifier - Glucose monitor supply for diabetic beneficiary treated with insulin

Last Updated Nov 26, 2019