Continuous Glucose Monitoring

Continuous Glucose Monitoring

Get Customized Support For Patients With Diabetes

Continuous Glucose Monitoring (CGM) lets patients work with their providers to track their blood glucose levels and reduce their A1C levels.

However, this benefit comes with other responsibilities for providers, including:

  • Determining patient qualification for the CGM device
  • Verifying health insurance
  • Processing claims
  • Onboarding new CGM device users
  • Providing adequate training and support

A Tailored Solution

St. Vincent Preventative Family Care will handle your administrative obligations — so you can focus on using CGM data to improve the care of patients with diabetes.

We serve as a direct link between your organization and numerous CGM brands.

As a DME-licensed organization, our goal is to:

  • Help you navigate the CGM device qualification process
  • Streamline insurance verification and billing
  • Ensure patients maximize their insurance benefits
  • Deliver CGM devices promptly to patients, in proper condition 
  • Offer extensive training to develop user confidence

Your patients need ongoing CGM-device support, and we are ready to oblige. We offer customized health coaching and medical alert management to:

  •  Engage patients as active partners in their healthcare journey
  •  Provide patients with peace of mind
  •  Increase patient trust in your organization

2021 Continuous Glucose Monitoring (CGM) CPT Coding Chart

Codes and descriptionMedicare physician office fee schedule1Medicare outpatient diabetes center2Private payer
(2021 averages)3		Relative value unit (RVU) non-facility1
CGM Services
        95249         Personal CGM – Startup/Training Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment, sensor placement, hook-up, calibration of monitor, patient training, and printout of recording. Bill only once during the time period that the patient owns the device.*$58.62
$55.66
APC 5733		$1281.68
        95250         Professional CGM Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; physician or other qualified health care professional (office) provided equipment, sensor placement, hook-up, calibration of monitor, patient training, removal of sensor, and printout of recording. Do not bill more than 1x/month.*$157.37
$118.74
APC 5012		$3094.51
        95251         CGM Interpretation Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis, interpretation and report. Do not bill more than 1x/month.*$35.59Paid under physician fee schedule$971.02

Are you ready to unload your CGM burdens?  Get in touch today.