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Policy Bulletin Update: RB.017.B Continuous Glucose Monitors

Health Partners Plans is updating an existing Policy Bulletin. Effective March 19, 2021, HPP will be implementing a revised policy for Continuous Glucose Monitors (CGM).

Continuous glucose monitoring measures glucose levels in the interstitial fluid through the use of a sensor placed under the skin. A transmitter sends information about glucose levels to a wireless monitor attached externally. These devices display glucose levels at either 1- or 5-minute intervals with the option to set alarms alerting the individual to abnormal glucose levels. Greater amounts of data collection may provide more insight regarding glucose patterns.

As a reminder, HPP’s medical policy bulletins define medical necessity criteria and coverage positions on topics such as medical services, procedures, DME, therapies, etc. Our claim payment policy bulletins provide reimbursement rules and billing guidelines necessary to ensure timely and appropriate payment.

You can find all policy bulletins at hpplans.com/PolicyBulletins.

New and updated policy bulletins are created, published, and updated as appropriate. Select new and updated policies, including RB.017.B Continuous Glucose Monitors, may be posted in notification format 30 days in advance of implementation. When published in advance, the policy bulletin document will clarify that the document is available for review but not yet implemented.

If you have questions or need further information, please call our Provider Services Helpline at 1-888-991-9023 (Monday to Friday, 9 a.m. to 5:30 p.m.).