Which insurance companies are paying for CPT codes 95249, 95250 and 95251? How do healthcare providers find out the specifics of each insurance company’s CGM coverage policy and criteria?

The majority of commercial insurance plans have written positive coverage decisions for both personal and professional use of CGM. National payers such as Cigna, Humana, Aetna, United Healthcare and Anthem WellPoint are currently covering these CPT codes, although the coverage criteria may differ between personal and professional use of CGM. Coverage decisions may vary and limit coverage to specific patients (i.e. type 1) or may limit number of times per year CPT codes 95249, 95250 and 95251 may be covered. Work with your health plans to get copies of the most recent published CGM coverage decisions. As always, verify coding and payment with your local payers.

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