MedicaidCoverageHigh impact
Continuous Glucose Monitoring and Insulin Delivery for Managing Diabetes (for Idaho Only)
UnitedHealthcare·ID · Endocrinology, Pediatrics, Internal Medicine +1 more·Medical Policy
Effective date
Oct 1, 2026
We identified it
Sep 2, 2026
Summary
UnitedHealthcare Community Plan of Idaho (Medicaid) updated its policy on Continuous Glucose Monitoring and Insulin Delivery effective October 1, 2026. Eight specific HCPCS and CPT codes (0446T, 0448T, S1030, S1031, S1034, S1035, S1036, S1037) are now flagged as NOT on the Idaho Medicaid Fee Schedule and may not be covered; billing teams must verify coverage through the Idaho Medicaid Provider Handbook before submitting claims for these codes.
Action Required
By October 1, 2026: Billing team must update claim submission procedures and billing system rules to flag CPT codes 0446T, 0448T and HCPCS codes S1030, S1031, S1034, S1035, S1036, S1037 for Idaho Medicaid patients. Before submitting any claims using these codes for Idaho Medicaid members, verify current coverage status in the Idaho Medicaid Provider Handbook under Non-Covered and Excluded Services section. Do NOT assume coverage—these codes may result in denials if billed without pre-verification. Train billing staff and providers serving Idaho Medicaid patients on this restriction. Update internal coverage policy documents and encounter forms if applicable. Failure to verify coverage will result in claim denials and potential recovery actions.