Medicare AdvantageCoverageMedium impact
How to Request a Continuous Glucose Monitoring Device
Healthfirst·Endocrinology, Family Medicine, Internal Medicine·Provider Update
We identified it
Jun 20, 2026
Summary
Healthfirst now allows members with Type 1 and Type 2 diabetes to request Continuous Glucose Monitoring (CGM) devices if they meet established eligibility criteria. This affects billing for CGM devices and related services for Healthfirst Medicare, Essential Plan, and Qualified Health Plan members.
Action Required
Immediately: Billing team should review current CGM device billing procedures for Healthfirst members with diabetes. Update patient eligibility verification processes to confirm diabetes diagnosis and check Healthfirst's specific CGM eligibility criteria before device orders. Contact Healthfirst directly for detailed eligibility requirements and prior authorization procedures.