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CMS Proposes Unique Codes For Continuous Glucose Monitoring

This article was originally published in The Gray Sheet

Executive Summary

CMS is proposing to establish unique codes for continuous glucose monitors, a decision that could help manufacturers secure reimbursement from both Medicare and private payors

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New codes for continuous glucose monitors

The next-generation devices are granted unique level-II HCPCS codes from CMS starting Jan. 1, 2008. Three codes will designate the CGM components: sensor, transmitter and receiver. The decision, released Nov. 5, finalizes the Medicare agency's spring proposal (1"The Gray Sheet" April 16, 2007, p. 6). Continuous glucose monitors on the U.S. market include Medtronic's Guardian Real-Time monitor and Paradigm Real-Time system with integrated insulin pump, and DexCom's Seven monitor. Abbott expects an early 2008 launch of its Freestyle Navigator continuous monitor, which remains under FDA review. The new codes represent a first step towards gaining broader coverage and reimbursement for the devices, for which patients generally pay out-of-pocket today

New codes for continuous glucose monitors

The next-generation devices are granted unique level-II HCPCS codes from CMS starting Jan. 1, 2008. Three codes will designate the CGM components: sensor, transmitter and receiver. The decision, released Nov. 5, finalizes the Medicare agency's spring proposal (1"The Gray Sheet" April 16, 2007, p. 6). Continuous glucose monitors on the U.S. market include Medtronic's Guardian Real-Time monitor and Paradigm Real-Time system with integrated insulin pump, and DexCom's Seven monitor. Abbott expects an early 2008 launch of its Freestyle Navigator continuous monitor, which remains under FDA review. The new codes represent a first step towards gaining broader coverage and reimbursement for the devices, for which patients generally pay out-of-pocket today

Medtronic Plans Nationwide Launch Of Next-Gen Glucose Monitor

Medtronic plans to launch its Guardian Real-Time continuous glucose monitoring system by the end of this year, the firm said July 17

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