MedicaidPrior AuthMedium impact
PT 71-26: Corrected Updated Coverage of Continuous Glucose Monitoring Systems
Maryland Medicaid·MD · Endocrinology, Family Medicine, Internal Medicine +1 more·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jun 18, 2026
Summary
Maryland Medicaid has expanded coverage for continuous glucose monitoring (CGM) systems effective January 1, 2026, now including Type 1 and Type 2 diabetics on insulin, gestational diabetes patients, and those with problematic hypoglycemia. All CGM requests require preauthorization through Telligen and must meet specific medical criteria including FDA-approved indications.
Action Required
Immediately: Billing team must ensure all CGM system requests for Maryland Medicaid patients include preauthorization from Telligen before submission. Update billing protocols to verify patients meet expanded criteria (Type 1/2 diabetes on insulin, gestational diabetes, or documented problematic hypoglycemia) and that treating practitioner has evaluated diabetes control within 6 months prior to ordering. Submit preauthorization requests through Telligen's Education and Training page process.