MedicaidCoverageMedium impact
VDP to Add Continuous Glucose Monitors to Formulary June 3, 2026
Texas Medicaid·TX · Endocrinology, Family Medicine, Internal Medicine +1 more·Pharmacy
Effective date
Jun 6, 2026
We identified it
Jan 12, 2026
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.