What billing codes are available to practices using CGMs?
Easier and faster billing is possible with these quick-access CGM codes.
CPT Code | Type of Service | Provider | Frequency | Type of Visit |
95249 | Personal CGM placement, start-up, training, and technical components | RN, PharmD/RPh, RD, CDE, or MA | Once for the lifetime of the CGM device | Face-to-face |
95250 | Professional CGM, physician or health professional (office) equipment, patient training, and technical components | RN, PharmD/RPh, RD, CDE, or MA | Once per month maximum | Face-to-face |
95251 | CGM Interpretation | Physician (MD, DO), NP, PA, or clinical nurse specialist | Once per month maximum | Face-to-face not required |
-25 modifier | Evaluation and Management (Separate Identifiable Service) Can be billed same day as 95249, 95250, and/or 95251 if documentation supports medical necessity | Physician (MD, DO), NP, PA, or clinical nurse specialist | With office visits. | Face-to-face |