MedicaidCoverageMedium impact
Confirmation of Coverage for Continuous Glucose Monitors per Public Act 102-1093
Illinois Medicaid - HFS·IL · Endocrinology, Family Medicine, Internal Medicine +1 more·Provider Notice
Effective date
Jul 25, 2022
We identified it
Jun 20, 2026
Summary
Illinois Department of Healthcare and Family Services confirms coverage for continuous glucose monitors (CGMs) under Public Act 102-1093 for patients with type 1 or type 2 diabetes who require insulin. Coverage applies to both Medicaid fee-for-service and HealthChoice Illinois managed care plans with no program changes needed.
Action Required
Immediately: Billing team should review CGM coverage criteria at HFS Illinois website under the Criteria heading to ensure proper billing for diabetic patients requiring insulin. For FFS billing questions, contact Bureau of Professional and Ancillary Services at 877-782-5565. For managed care questions, contact the applicable HCI MCO directly.