MedicaidPrior AuthMedium impact
Coverage of Continuous Glucose Monitoring Systems
Maryland Medicaid·MD · Endocrinology, Family Medicine, Internal Medicine +1 more·Provider Transmittal
We identified it
Jun 20, 2026
Summary
New Maryland Medicaid policy establishes specific clinical requirements and documentation for Continuous Glucose Monitoring (CGM) device coverage, requiring providers to complete attestation forms and meet strict eligibility criteria. Coverage is limited to Type 1 diabetes patients with specific clinical indicators including frequent severe hypoglycemia, hypoglycemic unawareness, or HbA1c levels ≥7.0%.
Action Required
Immediately: Providers treating Type 1 diabetes patients must use the new CGM attestation form when requesting Continuous Glucose Monitoring devices for Maryland Medicaid patients. Complete the pre-payment authorization form (DHMH-4527) along with the attestation form. Ensure prescribing physicians sign and date all forms. Document compliance with clinical requirements including insulin administration frequency, blood glucose monitoring compliance, and at least one of the specified clinical indicators (severe hypoglycemia, hypoglycemic unawareness, or HbA1c ≥7.0%).