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Changes to Pharmacy Claims for Dexcom G6-7 & Freestyle Libre 2 Monitoring Products pdf

Connecticut Medicaid (HUSKY Health)·CT · Endocrinology, Family Medicine, Internal Medicine +1 more·Pharmacy
Effective date
Mar 1, 2023
We identified it
Jun 20, 2026
Days to comply

Summary

Starting March 1, 2023, Connecticut Medicaid (HUSKY) will allow Dexcom G6, G7, and Freestyle Libre 2 continuous glucose monitors to be obtained through pharmacies with prior authorization, in addition to the existing DME benefit option. Patients can choose between pharmacy or DME vendor for their CGM supplies.

Action Required

Action needed
Before March 1, 2023: Billing team must update procedures to accommodate dual coverage pathways for CGM devices. Pharmacy claims require new Pharmacy CGM PA form (valid 12 months) available at www.ctdssmap.com. DME claims continue using existing medical authorization portal or fax to 203-265-3994. Update system to monitor for duplicate billing between DME and pharmacy benefits. Verify CGM devices are on Preferred Diabetic Supply Product List before pharmacy billing.

Affected Billing Codes

A6549