Texas MedicaidMedium ImpactCoverage
VDP to Add Continuous Glucose Monitors to Formulary June 3, 2026
Published January 12, 2026Effective June 6, 2026
AI Summary
Starting June 6, 2026, Texas Medicaid will move continuous glucose monitors (CGMs) from medical benefits to pharmacy benefits under the VDP formulary. Pharmacies must be enrolled as DME providers to receive reimbursement for CGM claims.
Action Required
Before June 6, 2026: Billing team must verify that all pharmacies dispensing CGMs are enrolled as DME providers with Texas Medicaid. Update billing workflows to submit CGM claims through pharmacy benefits instead of medical benefits. Monitor for additional implementation details from VDP in coming months.
Plan Types
Medicaid
States
TX
Specialties
endocrinology, family-medicine, internal-medicine, pediatrics