Continuous Glucose Monitoring (CGM)
Policy governing medical necessity and coverage considerations for FDA‑approved continuous glucose monitor systems (short‑term or long‑term) for members with type 1 or type 2 diabetes, and noting investigational uses. Affects Capital BlueCross members and providers administering CGM-related care.
Updated MN statement to only include Type 1 or Type 2 diabetes as gestational diabetes is not a covered indication.
Implantable CGM status changed over time: previously NMN, later MN as part of FDA approved CGMs, then returned to INV (investigational) language with no change in intent, and currently grouped with FDA approved CGMs earlier but later policy restricts covered indications.
Added HCPCS codes A4238, A4239, and E2102-E2103 and later added G0564-5; removed certain K and G codes in administrative updates.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.