Summary & Overview
HCPCS A9276: Invasive Subcutaneous CGM Sensor, 1-Day Supply
HCPCS Level II code A9276 denotes a disposable, invasive subcutaneous sensor supplied as a one-day unit for use with interstitial continuous glucose monitoring (CGM) systems. This code matters nationally because CGM technology is increasingly central to diabetes management, and accurate coding of sensor supplies affects coverage, patient access, and claims processing across payers.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of code definition and clinical context, payer coverage considerations, and common billing modifiers associated with CGM supplies. The publication outlines benchmarks for utilization and reimbursement practices where available and summarizes relevant policy themes impacting access to sensor supplies, such as medical necessity criteria and day-supply reporting.
The report equips billing managers, DME suppliers, and revenue cycle staff with the information needed to correctly identify the service line and typical sites of service for A9276, recognize where data is limited, and locate follow-up resources for payer-specific guidance. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code A9276 describes a disposable invasive sensor (subcutaneous) intended for use with a non-durable medical equipment interstitial continuous glucose monitoring system, with one unit representing a one-day supply. This code covers the single-day provision of the sensor element that is inserted subcutaneously to measure interstitial glucose levels.
Service type: Durable medical equipment supply component for continuous glucose monitoring (CGM) systems.
Typical site of service: Outpatient settings and ambulatory care where patients receive or are trained to use home-based CGM devices, as well as retail and specialty pharmacies that dispense daily sensor supplies.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with diabetes (type 1 or insulin-requiring type 2) who requires continuous interstitial glucose monitoring to optimize glycemic control. The device-related supply coded as A9276 represents a single-day disposable subcutaneous sensor used with a non-durable medical equipment interstitial continuous glucose monitoring (iCGM) system. Clinical workflow: a diabetes specialty clinician or trained diabetes educator reviews the patient’s indication for real-time or retrospective glucose trend monitoring, authorizes the iCGM supplies, and arranges delivery through durable medical equipment vendors or outpatient pharmacy. The patient or caregiver applies the sensor per manufacturer instructions in an outpatient clinic, diabetes education visit, or at home; the sensor remains in place for the manufacturer-specified wear period (typically multiple days, billed as daily units). Follow-up visits or telehealth contacts address sensor performance, calibration (if required by the device), insulin dosing adjustments, and data review. Typical sites of service include outpatient clinics, home use, ambulatory surgery centers only for placement-related procedural care when combined with other services, and hospital outpatient departments when inpatient-to-outpatient transition of diabetes management occurs.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — standard service |