Medicare AdvantageCoverageMedium impact
Glucose Monitoring – Continuous
Blue Cross Blue Shield of Rhode Island·RI · Endocrinology, Family Medicine, Internal Medicine·Physician / Facility
Effective date
Jun 1, 2021
We identified it
Jun 19, 2026
Summary
Effective June 1, 2021, implantable continuous glucose monitoring will be covered for Medicare Advantage plans when medical criteria is met, but remains non-covered for commercial plans. New modifiers KS (non-insulin dependent) and KX (insulin dependent) are now required for claims reimbursement, and unit limits are being added to test strips and lancets codes.
Action Required
Immediately: Billing team must update system to require modifiers KS (non-insulin dependent) or KX (insulin dependent) for all continuous glucose monitoring claims. Update encounter forms to remind providers to specify insulin dependence status. Verify unit limits for test strips (A4253) and lancets (A4259) in billing system. Claims without proper modifiers will not be reimbursed.