This analysis does not need to be performed face-to-face with the patient.

The CPT code 95251 is for the analysis and interpretation of CGM data. CPT code 95250 may be appropriate for retrospective CGM and for the initial training, hookup, download, etc. CPT 95250 is used for the technical component of Continuous Glucose Monitor and covers patient training, glucose sensor placement, monitor calibration, use of a transmitter, removal of a sensor, and downloading of data. There are currently two Current Procedural Terminology (CPT) codes for CGM: 9521. As such, claims for adjunctive CGMs and related supplies and accessories can now be covered under the Part B DME benefit category when the system meets the DME definition.

This rule expanded the classification of DME to a larger group of CGMs, regardless of whether the CGMs are non-adjunctive (can replace standard blood glucose monitors for treatment decisions) or adjunctive (do not replace standard blood glucose monitors for treatment decisions). This final rule addressed the classification and payment of continuous glucose monitor (CGMs) under the Medicare Part B benefit for durable medical equipment (DME). On December 28, 2021, the Centers for Medicare & Medicaid Services (CMS) published a final rule which was implemented on February 28, 2022.

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