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MedicaidBilling CodesMedium impact

Codes K0553 and K0554 for Therapeutic Continuous Glucose Monitors pdf

Connecticut Medicaid (HUSKY Health)·CT · Endocrinology, Family Medicine, Internal Medicine·Provider Bulletin
Effective date
Mar 1, 2020
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid added new billing codes K0553 and K0554 for therapeutic continuous glucose monitors (CGM) like FreeStyle Libre, requiring prior authorization and specific frequency limits. These new codes replace existing codes for therapeutic CGM billing and include bundled supplies that cannot be billed separately.

Action Required

Action needed
By March 1, 2020: DME billing teams must use codes K0553 and K0554 for all therapeutic CGM systems (including FreeStyle Libre) instead of A9276-A9278 codes. Obtain prior authorization for all therapeutic CGM claims. Stop billing supply codes A4233-A4259, E0607, and E2101 separately when K0553 is billed in the same month as these are now bundled. Update billing system with frequency limits: K0553 (1 per month), K0554 (1 per 3 years). Claims will be denied if bundled supplies are billed separately or frequency limits are exceeded.

Affected Billing Codes

K0553
K0554
A9276
A9277
A9278
A4233
A4234
A4235
A4236
A4244
A4245
A4246
A4247
A4250
A4253
A4255
A4256
A4258
A4259
E0607
E2101