Resources for Prescribing & Filling CGM

The Dexcom G5® Mobile Continuous Glucose Monitoring (CGM) System is available by prescription and may be available at your patient's local pharmacy or through Durable Medical Equipment (DME). 

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Required documentation for prescribing CGM to Medicare patients

When prescribing a Dexcom CGM System to a Medicare patient, the Assignment of Benefits form is a necessary part of the document package for Medicare reimbursement. This form is to...

Use this Certificate of Medical Necessity (CMN) to document medical necessity of Dexcom CGM for your commercially insured patients. This fillable form can also serve as the prescription.

The first prescription should include three items: 1 receiver, 1 wireless transmitter, and 1 four-pack of sensors.

1 Receiver

(Indicated for one-year use)

Prescribe Dexcom G5 Mobile CGM for your intensive insulin therapy patients. See the sample prescription below.

Dexcom Continuous Glucose Monitoring (CGM) Systems are currently available for order via Cardinal, McKesson and AmerisourceBergen. Please see the chart below for appropriate order numbers.

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