DexCom, Inc., announced the new Dexcom G6® continuous glucose monitoring system (CGM), will be covered for Medicare beneficiaries in the U.S. beginning as early as 2019.Those who are eligible would have met the category requirements for therapeutic CGM systems by the U.S. Centers for Medicare & Medicaid Services (CMS).
Coverage for therapeutic CGM includes certain beneficiaries who have either Type 1 or Type 2 diabetes and intensively manage their insulin.According to CMS, therapeutic CGM may be covered by Medicare when all of the following criteria are met:
The beneficiary has diabetes mellitus andThe beneficiary has been using a home blood glucose monitor (BGM) and performing frequent (four or more times a day) BGM testing andThe beneficiary is insulin-treated with multiple daily injections (MDI) of insulin or a continuous subcutaneous insulin infusion (CSII) pump andThe beneficiary’s insulin treatment regimen requires frequent adjustment by the beneficiary on the basis of therapeutic CGM testing results andIn six (6) months prior to ordering the CGM, the beneficiary had an in-person visit with the treating practitioner to evaluate their diabetes control and determine that the above criteria are met andEvery six (6) months following the initial prescription of the CGM, the beneficiary has an in-person visit with the treating practitioner to assess adherence to their CGM regimen and diabetes treatment plan.“The Dexcom G6 is a game-changer for people with diabetes, and we are thrilled to provide this innovative technology to the many Americans with diabetes who rely on Medicare,” said Kevin Sayer, President and CEO of Dexcom in a statement.
“With the CMS policy coverage, Medicare beneficiaries with diabetes who use G6 will no longer require fingersticks to make treatment decisions or calibrate their CGM,” he added.
The company expects to begin shipping product to Medicare customers in the first part of 2019.