MedicaidCoverageMedium impact
22-466m Members Get More Coverage for Medical Supplies under Medi-Cal Rx
Health Net·CA · Endocrinology, Family Medicine, Internal Medicine +1 more·Prior Authorization
Effective date
May 1, 2022
We identified it
Jun 20, 2026
Summary
Medi-Cal Rx expanded coverage for diabetic supplies and home blood pressure monitors effective May and June 2022. Therapeutic continuous glucose monitors now allow up to 3 sensors per 30 days (9 per 90 days) but still require prior authorization, and personal home blood pressure monitors are now covered as pharmacy-billed items.
Action Required
Immediately: Billing team must verify current prior authorization processes for therapeutic CGM devices align with updated quantity limits (3 sensors per 30 days, 9 per 90 days). Update billing workflows to include home blood pressure monitors as pharmacy-billed items under Medi-Cal Rx. Reference the updated covered device lists on Medi-Cal Rx website for specific eligible products and quantity restrictions.