Coverage of CGM system supplies and accessories are available for those therapeutic CGM systems where the beneficiary uses a receiver classified as DME to display glucose data. There is no Medicare benefit for supplies used with equipment that is not classified as DME. However, Medicare coverage is available for the CGM system supplies and accessories if a non-DME device (smartphone, smart watch, tablet, etc.) is used in conjunction with the durable CGM receiver. Coverage of CGM system supplies and accessories are available for those therapeutic CGM systems where the beneficiary uses a receiver classified as DME to display glucose data. If a beneficiary intends to never use a receiver classified as DME as the display device, the supplies and accessories are not covered by Medicare. 

Here are some examples of how a Medicare patient may use a smart device with their receiver: 

• A patient uses both a receiver and a smartphone throughout the day 

• A patient uses a receiver some days and their smartphone other days  

Patients should reach out to 1-800-MEDICARE with any questions about the Medicare coverage requirements for Dexcom CGM. 

Visit  www.dexcom.com/medicare  to view online training videos. These videos can walk your patients through the steps to get started, including receiver and app set-up, and downloading Dexcom CLARITY 

Still need help? Call Dexcom Product Education & Training to speak with a Diabetes Coach at 877-339-2664. 

For technical troubleshooting, our specialists are available 24/7 at 844-607-8398. 

• New/Existing Pump Patients – Since it may take some time for our insulin pump partners to integrate Dexcom G7, we recommend that HCPs continue to prescribe G6 to new and existing connected pump patients until G7 is compatible with current and future automated insulin delivery systems. 

• New/Existing Patients at the Pharmacy – Dexcom G7 will be available at the pharmacy on February 17, for new and existing patients who are not using a connected insulin pump.  HCPs can send their prescriptions to ASPN Pharmacies, who will coordinate fulfillment with patients at the pharmacy of their choice.  For new and existing patients who are using a connected insulin pump, HCPs should continue to prescribe G6 until G7 is compatible with current and future automated insulin delivery systems. 

• New/Existing Patients at the DME Provider – Dexcom G7 will be available at Durable Medical Equipment providers on February 17th for new and existing patients who are not using a connected insulin pump.  HCPs can send their prescriptions to their DME supplier, who will coordinate fulfillment with patients.  For new and existing patients who are using a connected insulin pump, HCPs should continue to prescribe G6 through their DME supplier until G7 is compatible with current and future automated insulin delivery systems. 

• New Medicare Patients – You will need to provide your patients with a new prescription for G7 and work through their DME supplier to have it fulfilled. For new Medicare patients who are using a connected insulin pump, you should continue to prescribe G6 through their DME supplier until G7 is compatible with current and future automated insulin delivery systems. 

• Existing Medicare Patients – Once the patient’s G6 transmitter has expired, you will need to provide your patients with a new prescription for G7 and work through their DME supplier to have it fulfilled. For existing Medicare patients who are using a connected insulin pump and their G6 transmitter has expired, HCPs should continue to prescribe G6 through their DME supplier until G7 is compatible with current and future automated insulin delivery systems. 

You can order through your TBM or by visiting provider.dexcom.com

Yes, HCPs will be able to request G7 samples via their sales rep and from Dexcom's Provider website (provider.dexcom.com). HCPs can also request up to 5 G6 samples per month from the website.  

You can order G7 samples through your TBM starting on March 6, 2023.

Dexcom Receiver Limited Warranty ⁹ 

Dexcom, Inc. Or its local Dexcom affiliate (“Dexcom”) provides a limited warranty to individual end users (“you” or “user”) that the Dexcom receiver (the “receiver”) is free from defects in material and workmanship under normal use (”limited warranty”) for the period commencing on the date of original purchase and expiring one (1) year thereafter, provided it is not modified, altered, or misused. 

Note: If you received this receiver as a replacement for an in-limited-warranty receiver, the limited warranty for the replacement receiver shall continue for the remaining limited warranty period on the original receiver, but the replacement is not subject to any other warranty. 

Dexcom Sensor Limited Warranty ⁹ 

To the extent allowed by law, the Dexcom G7 sensor is provided to you without any warranty by Dexcom. Dexcom hereby disclaims all warranties (express, implied, and statutory) with respect to the sensor, including the implied warranties of merchantability and fitness for a particular purpose. There are no warranties which extend beyond the description herein. 

9 Dexcom G7 User Guide 

Dexcom G7 is easy to get no matter your patients CGM coverage! Exact pricing will vary depending on their specific health plan. 

• For patients with commercial insurance, health plans are adding coverage for Dexcom G7 each week. If a patient currently uses Dexcom G6 with a connected insulin pump, we recommend continuing it until Dexcom G7 adds compatibility with their pump or pen. Dexcom is working with our insulin delivery partners to integrate with Dexcom G7 as soon as possible. Terms and conditions apply. Dexcom Savings Center. 
• For those with Medicare coverage,** Dexcom G7 is covered for eligible patients (Medicare coverage criteria). For new patients, complete the Get Started form to get a free benefits check so we can determine your exact pricing. For current G6 patients, please contact your distributor for pricing and upgrading options.   
• For patients without CGM coverage, we invite them to take advantage of our Pharmacy Savings program to save over $200/month on Dexcom G7. Your patient can learn more at the Dexcom Savings Center. If a patient currently uses Dexcom G6 with a connected insulin pump, we recommend continuing it until Dexcom G7 adds compatibility with their pump or pen. Dexcom is working with our insulin delivery partners to integrate with Dexcom G7 as soon as possible. Terms and conditions apply. Dexcom Savings Center.  

** Under Medicare’s DME fee schedule, reimbursement for CGMs, using CPT codes K0554 and K0553, is the same, regardless of CGM brand. Regulation at 42 CFR 410.152(b), stipulates that coinsurance for items of durable medical equipment is 20% of the allowed amount. 

Dexcom does have pharmacy voucher program through GoodRX for Dexcom G7. Patients will get a 30-day pack of G7 sensors at $200 off the WAC price. Terms and conditions apply. Dexcom Savings Center. 

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Dexcom’s goal is to achieve parity access for G7 vs. G6 within one year of launch.  We expect to secure coverage like G6 for each Medicaid state.  Each state has individual policies, review timelines, and criteria for new products.  Continue to work closely with your DBM and RAE to understand your local coverage as it evolves.  Note, programs like the Simple Start program do not apply to Medicaid patients.