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Dexcom CGM offers comprehensive, affordable, and accessible coverage
Dexcom is committed to expanding CGM coverage for patients with all types of diabetes
Access to Dexcom CGM is easier than ever, with fewer plans requiring prior authorizations*,1
Formulary Lookup Tool
Quickly check formulary coverage for Dexcom CGM in your area
Coverage Evaluator
Check here to quickly determine a patient’s coverage for Dexcom CGM. Get results in seconds
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Medicare
A win for Medicare patients on insulin:
100% coverage of G7 15 Day†,2
Your Medicare and Medicare Advantage patients with diabetes may qualify if they have any one of the following:
1They take insulin
(type 1 diabetes, ICD-10 Code E10.-,Z79.4)
(type 2 diabetes, ICD-10 Code E11.-,Z79.4)2They have more than 1 level-2 hypoglycemic event‡
(glucose levels <54 mg/dL, ICD-10 Code E16.A2)
3They've had 1 level-3 hypoglycemic event‡
(glucose levels <54 mg/dL requiring third-party assistance, ICD-10 Code E16.A3)
The Dexcom CGM system is more accessible to qualifying insulin-treated Medicare patients than ever before†,3
3 out of 4
Medicare Advantage patients pay $0 at the pharmacy*,4
DME Distributors: Dexcom CGM is available for Medicare FFS and Medicare Advantage patients nationwide
Dexcom CGM can be shipped or conveniently delivered to a patient’s home
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How to prescribe the Dexcom CGM system for Medicare patients
Follow these four simple steps to get your Medicare patients started quickly:
Ensure that the chart notes verify that the Medicare patient meets the criteria above
Send the patient’s prescription/certificate of medical necessity, and chart notes to one of the distributors listed below
Let your patient know that they will be contacted by the distributor regarding their Dexcom CGM order
Make sure your patient has an in-person visit within 6 months of starting CGM and every 6 months thereafter
Definition ICD-10 Code Documentation They take insulin Type 1 diabetes E10.-,Z79.4 Type 2 diabetes E11.-,Z79.4 They have more than 1 level-2 hypoglycemic event Glucose level <54 mg/dL E16.A2 Glucose log showing the qualifying events and evidence of prior treatment adjustment They have 1 level-3 hypoglycemic event Glucose levels <54 mg/dL requiring third-party assistance E16.A3 Glucose log showing the qualifying event and that the patient required third-party assistance ICD-10 Code They take insulin Type have more than 1 level-2 hypoglycemic event They have 1 level-3 hypoglycemic event Definition Type 1 diabetes Type 2 diabetes Glucose levels [54 mg/dl Glucose levels [54 mg/dl requiring third-party assistance ICD-10 Code E10.-,Z79.4 E11.-,Z79.4 E16.A2 E16.A3 Documentation Glucose log showing the qualifying events and evidence of prior treatment adjustment Glucose log showing the qualifying event and that the patient required third-party assistance
DISTRIBUTOR PHONE NUMBER
FAX NUMBER
AdaptHealth
/Solara Medical Supplies800-423-0896 opt 2
800-999-7021
Byram Healthcare
800-775-4372
888-457-1277
CCS Medical
800-949-6481
866-823-4482
Edgepark
/Advanced Diabetes Supplies866-400-5183
866-510-6583
Edwards Healthcare
888-344-3434
502-657-0237
Premier Kids Care
888-892-9001
866-810-4021
Have additional Medicare questions?
CGM=continuous glucose monitoring; CPT=Current Procedural Terminology; DME=durable medical equipment; FIA=Formulary Impact Analyzer; FFS=fee-for-service; ICD=International Classification of Diseases.
*Coverage may vary by insurance plan. †The local coverage determination expands coverage of CGM and related supplies to Medicare beneficiaries treated with insulin at least once daily or with a history of problematic hypoglycemia. For the full list of Medicare coverage criteria, visit the Centers for Medicare and Medicaid Services website. ‡Documentation required: Glucose log showing the qualifying events and evidence of prior treatment adjustment. §Documentation required: Glucose log showing the qualifying event and that the patients required third-party assistance.
1 Data on file (VV-07407). Dexcom; 2025. 2 Data on file (VV-06660). Dexcom; 2024. 3 Dexcom G7 User Guide 2025. 4 Data on file (VV-06805). Dexcom; 2024.
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Veterans
Dexcom G7 can help veterans manage their diabetes with confidence
Prescribe the #1 recommended CGM brand for your VA patients2,3
Dexcom G7 is the easier way for VA patients to manage diabetes†
The Dexcom G7 Continuous Glucose Monitoring (CGM) System allows your patients to see their glucose levels 24/7 without the hassle of fingersticks.‡ It uses a small wearable sensor to send glucose numbers to a smartphone§ or handheld display device in real time.
This powerful tool can help patients living with all types of diabetes see the impact of food, activity, and medication on their glucose levels so they can
make better decisions in the moment. Dexcom G7 is available for qualifying VA patients.†Image
See how Dexcom CGM changed a veteran’s life
Confident therapy decisions that lead to proven results4-8
LOWERED A1C AND INCREASED TIME IN RANGE
With Dexcom CGM, reduction in A1C was seen patient group, regardless of baseline4,6-8
SUPPORTS GREATER PEACE OF MIND
The Dexcom G7 family offers the most advanced set of customizable alerts to help keep you in range.9,10
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The simple CGM system
For easier diabetes management that leads to better treatment adherence.||,11
Say Dexcom G7 is easy to use
96% of surveyed Dexcom G7 customers say it’s easy to use9
Improved adherence
Intuitive diabetes management that leads to better adherence12
#1 in patient satisfaction¶,2
Dexcom customers are significantly more satisfied vs. Libre#,2,3
VA elegible criteria†
Providers prescribing CGM devices for Veterans must confirm and document the Veteran has been diagnosed with diabetes and is being treated with daily insulin. Veterans taking insulin daily are eligible for a CGM device. It is recommended that CGM be considered under the following circumstances:
- The Veteran requires daily insulin to achieve desired glycemic management targets and/or avoid hypoglycemia based on shared decision-making, as recommended by the VA/DoD Clinical Practice for the Management of Diabetes Mellitus.
- The Veteran has an uncommon condition in which hypoglycemia is a significant concern (for example, post-gastrectomy, paraneoplastic syndromes, and reactive hypoglycemia). These Veterans may be considered on a case-by-case basis by the endocrinology subject matter expert at the VISN or facility.
- It is documented that the Veteran has the knowledge and skill set necessary to successfully utilize CGMs, including an understanding of the need to do self- monitoring blood glucose (SMBG) for calibration as recommended by the manufacturer, and to evaluate “high” or “low” blood glucose results or trends based upon readings and/or alarms as recommended by the FDA and the treating healthcare team.
- It is documented that the Veteran has followed provider recommendations for SMBG and therapy changes. This will assist providers with determining potential adherence with CGMs, which is essential in achieving improved outcomes.
- The Veteran agrees to ongoing medical appointments with the multidisciplinary team at least every 6 month (more frequently as recommended) to assess the adherence and benefit derived from CGMs, which will be documented in the medical record and used for justification for continued use.
Dexcom G7 can help veterans with all types of diabetes better manage their glucose9
DEXCOM G7 CGM FOR PERSONAL USE
An intuitive user experience with the advanced accuracy that only Dexcom offers9,13,14
How to prescribe
10-day sensor
NRC CODE:08627-0077-01
Fill 3 boxes (1 sensor per box, refill every 30 days)
Receiver (optional)**
NRC CODE:08627-0078-01
Fill 1 (Refill every year)
Compatible smartphones sold separately: dexcom.com/compatibility
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Request a meeting with a Federal Business Manager
A Dexcom Federal Business Manager will reach out to set up a virtual or in-person meeting to answer your questions.
A1C=hemoglobin A1C; CGM=continuous glucose monitoring; DoD=US Department of Defense; FDA=Food and Drug Administration; FIA=Formulary Impact Analyzer; NPS=Net Promoter Score; NRC=National Reimbursement Code; VA=Department of Veteran's Affairs; VISN=Veterans Integrated Service Network.
*Coverage may vary by insurance plan. †For a complete description of Veterans Affairs coverage criteria and additional information, please see the Department of Veterans Affairs (VA) Updated Guidance on Patient Selection Criteria for Continuous Glucose Monitoring Systems (CGMs), June 30, 2022. A patient must be seen at a VA healthcare facility or a VA Community Care Network clinic to be eligible to receive coverage. ‡Fingersticks required for diabetes treatment decisions if symptoms or expectations do not match readings. §Smart device sold separately. To view a list of compatible devices, visit dexcom.com/compatibility. ||An internet connection is required for users to send their glucose data to Dexcom Clarity via a compatible smart device: dexcom.com/compatibility. ¶Based on a comparison in NPS scores across major CGM brands. #Dexcom G7 overall satisfaction rating as compared to Medtronic Guardian Sensor 3, Guardian Sensor 4, Abbott FreeStyle Libre 2, and FreeStyle Libre 3. **Receiver required for Medicare beneficiaries.
1 Data on file (VV-07407). Dexcom; 2025. 2 Seagrove Patient Survey 2024. 3 Seagrove HCP Survey Q3 2024. 4 Beck RW, et al. JAMA. 2017;317(4):371-378. 5 Beck RW, et al. Ann Intern Med. 2017;167(6):365-374. 6 Martens T, et al. JAMA. 2021;325(22):2262-2272. 7 Laffel LM, et al. JAMA. 2020;323(23):2388-2396. 8 Welsh JB, et al. J Diabetes Sci Technol. 2024;18(1):143-147. 9 Dexcom G7 User Guide 2025. 10 Dexcom G7 15 Day User Guide 2025. 11 Polonsky WH, et al. Diabetes Technol Ther. 2022;24(7):492-501. 12 Nemlekar P, et al. Diabetes Ther. 2024;15(3):639-648. 13 Garg SK, et al. Diabetes Technol Ther. 2022;24:1-8. 14 Garg SK, et al. Diabetes Technol Ther. 2025;27(6):413-502.
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