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    v1.0.28
    OpenPayerBilling CodesDurable Medical EquipmentHCPCS hcpcs-e2103-non-adjunctive-continuous-glucose-monitor
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    HCPCS Level II E2103: Non-adjunctive Continuous Glucose Monitor/Receiver

    Commercial payers pay $157 on average nationally for this procedure.

    HCPCS Level II code E2103 describes a non-adjunctive, non-implanted continuous glucose monitor or receiver used as a replacement for standard home glucose monitoring; service type is durable medical equipment and the typical site of service is home use or outpatient settings where continuous glucose monitoring is managed.

    For related coverage guidance, see recent payer policy updates: Interferential Stimulation Devices (for home use), Prior Authorization for Durable Medical Equipment (DME), Breast Pumps.

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    National Reimbursement Benchmarks

    Commercial reimbursement for HCPCS E2103 centers on a BUCA average of $157.20, with individual payers showing meaningful differences in central tendency and dispersion. Blue Cross Blue Shield (BCBS) and Cigna both sit above BUCA on mean values ($189.10 and $115.70 respectively relative to BUCA’s $157.20 for mean), while Aetna ($95.90) and UnitedHealth Group ($132.00) are lower or similar. The presence of high maxima for BCBS ($971.40) and UnitedHealth Group ($415.60) indicates occasional outlier payments that elevate their upper tails, whereas BUCA represents an average commercial benchmark without min/max detail.

    Rate dispersion (P75 minus P25) highlights variability by payer: Blue Cross Blue Shield shows the widest interquartile spread at $172.00 (P75 $252.00 minus P25 $80.00), followed by Cigna at $168.80 (P75 $181.90 minus P25 $15.10). UnitedHealth Group’s spread is $84.70 (P75 $168.70 minus P25 $84.30), and Aetna is the tightest at $37.10 (P75 $157.90 minus P25 $18.00). BUCA’s IQR is $160.20 (P75 $216.70 minus P25 $62.50), placing it between the more and less variable commercial payers.

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    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old patient with insulin-requiring diabetes and difficulty with frequent fingerstick monitoring presents for durable medical equipment evaluation. The clinician documents recurrent hypoglycemia unawareness and variability in glucose levels despite insulin adjustments. The non‑adjunctive continuous glucose monitor (CGM) or receiver is ordered to replace standard home blood glucose monitors and supplies. The clinical workflow includes: referral or order from the treating clinician, prior authorization submission to the patient’s payor (for example, Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, BUCA, Medicare), verification of medical necessity using documented diagnoses and evidence of insulin therapy or recurrent hypoglycemia, delivery and patient education by a Durable Medical Equipment (DME) supplier, and device setup with initial training on real‑time glucose alerts and data reporting. Ongoing care includes periodic data review during follow‑up visits, supply reorders using associated supply allowance codes, and device replacement per manufacturer lifespan and payer policy.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    E2100Standard home blood glucose monitor (old code)Replaced by a non‑adjunctive CGM (E2103) when the CGM is furnished; used historically for supply and equipment comparisons.

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    225100000XPhysical TherapistPhysical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who…
    225X00000XOccupational TherapistAn occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for O…
    332B00000XDurable Medical Equipment & Medical SuppliesA supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for…
    227900000XRegistered Respiratory TherapistA Registered Respiratory Therapist (RRT) is an advanced therapist who has passed standardized written and clinical simulation examinations administere…
    2080H0002XPediatric Hospice and Palliative Medicine PhysicianA pediatrician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This speci…
    247100000XRadiologic TechnologistA medical imaging or radiation therapy professional who is appropriately educated and trained to perform medical imaging procedures using ionizing and…
    174MM1900XMedical Research VeterinarianOther Service Providers · Veterinarian
    225XF0002XFeeding, Eating & Swallowing Occupational TherapistOccupational therapists provide interventions to clients of all ages with feeding, eating and swallowing difficulties. Occupational therapists provid…

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    10 rows

    PolicyPayerEffective Date
    Interferential Stimulation Devices (for home use)Moda Health2026-10-01
    Prior Authorization for Durable Medical Equipment (DME)Blue Cross Blue Shield - Rhode Island2026-10-01
    Breast PumpsModa Health2026-09-01
    Personal Emergency Response SystemsCareSource Georgia2026-09-01
    Continuous Passive Motion (CPM) DevicesCigna2026-08-15
    Push-Rim Activated Power-Assist Device (E0986) — Manual Wheelchair Accessorymoda_health_plan_inc2026-08-13
    Beds and Mattresses (for Ohio Only)Colorado Rocky Mountain Health Plans2026-08-01
    Beds and Mattresses (for Kentucky Only)UnitedHealthcare2026-08-01
    Pneumatic Compression Devices (for Nebraska Only)UnitedHealthcare2026-08-01
    Indications for Coverage — Hospital beds, support surfaces, and safety enclosure beds (DME)Colorado Rocky Mountain Health Plans2026-08-01

    Related Codes

    HCPCS-E0100-CANE-DURABLE-MEDICAL-EQUIPMENT-AMBULATION

    HCPCS E0100: Cane, Adjustable or Fixed, With Tip

    HCPCS-E0105-CANE-QUAD-THREE-PRONG-MOBILITY-AID

    HCPCS Level II E0105: Cane, Quad or Three-Prong, Includes Tips

    HCPCS-E0110-FOREARM-CRUTCHES-PAIR-DME-MOBILITY

    HCPCS Level II E0110: Forearm Crutches, Pair, Complete with Tips and Handgrips

    HCPCS-E0111-CRUTCH-FOREARM-DURABLE-MEDICAL-EQUIPMENT

    HCPCS Level II E0111: Crutch, Forearm, With Tip and Handgrips

    HCPCS-E0112-UNDERARM-WOOD-CRUTCHES-PAIR

    HCPCS Level II E0112: Underarm Wooden Crutches, Pair

    HCPCS-E0113-CRUTCH-UNDERARM-WOOD-ADJUSTABLE-FIXED-WITH-PAD-TIP-HANDGRIP

    HCPCS Level II E0113: Crutch Underarm, Wood, Adjustable or Fixed

    HCPCS-E0114-UNDERARM-CRUTCHES-PAIR-ADJUSTABLE-FIXED

    HCPCS Level II E0114: Underarm (Axillary) Crutches, Adjustable or Fixed, Pair

    HCPCS-E0116-UNDERARM-CRUTCH-NON-WOOD-ADJUSTABLE-FIXED

    HCPCS E0116: Underarm Crutch, Non-Wood, Adjustable/Fixed with Pad

    HCPCS-E0117-ARTICULATING-SPRING-ASSISTED-UNDERARM-CRUTCH

    HCPCS Level II E0117: Crutch, Underarm, Articulating, Spring-Assisted

    HCPCS-E0118-LOWER-LEG-PLATFORM-CRUTCH-SUBSTITUTE

    HCPCS E0118: Crutch Substitute, Lower Leg Platform

    Showing 1–10 of 670

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    E2101Standard home blood glucose monitor (alternate)Replaced by E2103 when the non‑adjunctive CGM is furnished; related to device substitution in payer and inventory records.
    E0607Standard home blood glucose monitorReplaced by E2103 for non‑adjunctive CGM provision; appears in prior policy language and claims transitions.
    A4233Supply allowance for standard BGMsReplaced when E2103 is billed; used historically for lancets and strips supply allowances.
    A4234Supply allowance for standard BGMsReplaced when E2103 is billed; similar supply allowance role.
    A4235Supply allowance for standard BGMsReplaced when E2103 is billed; related to consumable supplies for fingerstick meters.
    A4236Supply allowance for standard BGMsReplaced when E2103 is billed; another legacy supply code for BGMs.
    A4239Supply allowance for non‑adjunctive CGM devicesUsed for periodic consumable supplies associated with a non‑adjunctive CGM; billed alongside E2103 per payer supply allowance policies.