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Continuous Glucose Monitoring
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
Implantable continuous glucose monitoring devices for management of type 1 and type 2 diabetes may now be considered medically necessary for individuals 18 years of age or older who meet the medical necessity criteria for a non-implanted CGM device. The policy history records this change on 05/15/2026, when this statement changed from investigational to medically necessary, and when CPT codes 0446T, 0447T and 0448T were added to the Code Reference section. The same entry removed HCPCS codes G0564 and G0565 from the Code Reference section.
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What to do
Action · 5 steps
01REQUIREMENTS: Billing team: Implanted CGM devices for management of type 1 and type 2 diabetes may be considered medically necessary when the individual is 18 years of age or older and meets the medical necessity criteria for a non-implanted CGM device.
02Billing team: CPT 0446T (creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor, including system activation and patient training), 0447T (removal of implantable interstitial glucose sensor from subcutaneous pocket via incision) and 0448T (removal with creation of a subcutaneous pocket at a different anatomic site and insertion of a new implantable sensor, including system activation) are listed as covered codes that are only medically necessary when the procedure is performed according to the policy section.
03Billing team: For long-term CGM in type 1 diabetes, document that the individual has demonstrated an understanding of the technology, is motivated to use the device correctly and consistently, is expected to adhere to a comprehensive diabetes treatment plan supervised by a qualified provider, and is capable of using the device to recognize alerts and alarms.
04Billing team: Other uses of long-term and short-term CGM, including use in gestational diabetes not requiring insulin therapy, are considered investigational.
05Billing team: Review the member's specific benefit plan language before billing these services, because the Medical Policy Manual should not be used in place of that language.
Codes mentioned
G0564G0565
Original notice
Continuous Glucose Monitoring
bcbsms.com · Always check the source before changing claims.