MedicaidCoverageMedium impact
Clarifying Guidance of MEDS Policy Pertaining to Procedure Codes K0553 and K0554 for Therapeutic Continuous Glucose Monitors pdf
Connecticut Medicaid (HUSKY Health)·CT · Endocrinology, Family Medicine, Internal Medicine +1 more·Provider Bulletin
Effective date
Mar 1, 2020
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid has updated billing guidance for therapeutic continuous glucose monitors (CGM) using codes K0553 and K0554. The policy clarifies reimbursement rates, bundled supply requirements, and different processes for obtaining additional supplies for children versus adults.
Action Required
Immediately: DME providers must ensure K0553 claims include all required monthly supplies (lancets, test strips, alcohol wipes) and obtain separate prescriptions for these supplies. Update billing system to prevent separate billing of codes A4233-A4259, E0607, and E2101 in the same month as K0553. For additional supplies: children under 21 must obtain extras through pharmacy benefit, adults 21+ require prior authorization with blood glucose logs from preceding 15 days.