ModifiedMolina HealthcarePolicy G2006
Diabetes Mellitus Testing (A1c, FPG, OGTT) - Coverage and Payment
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Defines Molina Healthcare's coverage criteria and limitations for diagnostic and monitoring tests for diabetes mellitus (A1c, fasting plasma glucose, and oral glucose tolerance testing) across patient populations and clinical scenarios.
Policy Summary
PayerMolina Healthcare
PolicyDiabetes Mellitus Testing (A1c, FPG, OGTT) - Coverage and Payment
Policy CodePolicy G2006
Change TypeCriteria additions and removalreference updates
Effective DateApr 1, 2025
Last ReviewApr 1, 2025
Next Review DateApr 1, 2025
Key ActionVerify member benefits at time of request and consult updated criteria when seeking authorization or submitting claims.
SourceLink
POLICY UPDATE CHANGES
Addition of CC2e: 'e) Quarterly for individuals who are pregnant.'
Addition of CC5i: 'i) For individuals with metabolic dysfunction-associated steatotic liver disease (MASLD).'
Removed Note 1 which previously stated that according to the ADA, plasma glucose measurement alone can diagnose diabetes in a patient with classic symptoms.
Updated background, guidelines, and evidence-based scientific references after literature review.
≥6.5%A1c diagnostic threshold
q3yAsymptomatic screening interval
annualPrediabetes screening
monthlyPregnancy testing frequency
6CPT/HCPCS codes listed
>30References cited
Coverage Criteria for Diabetes Testing
Coverage decision nodes
Tests that meet or do not meet coverage criteria as specified by clinical situation and population.
For individuals with acute or persistent classic symptoms of diabetes mellitus: measurement of plasma glucose meets coverage criteria.
ALL of the following
- a) Upon initial diagnosis to establish a baseline value and to determine treatment goals.
- b) Twice a year (every 6 months) in individuals who are meeting treatment goals and who appear to have stable glycemic control based on daily glucose monitoring.
- c) Quarterly in individuals who are not meeting treatment goals for glycemic control.
- d) Quarterly in individuals whose pharmacologic therapy has changed.
- e) Quarterly for individuals who are pregnant.
- f) Every 60 days in individuals with poorly controlled diabetes.
For prediabetic individuals: annual screening for type 2 diabetes with a fasting plasma glucose test or measurement of hemoglobin A1c meets coverage criteria.
For asymptomatic individuals age ≥35 with no risk factors: screening for prediabetes or type 2 diabetes once every 3 years with a fasting plasma glucose test meets coverage criteria.
ALL of the following
- Risk factors include: overweight or obesity; first-degree relatives with diabetes; history of cardiovascular disease; hypertension; hypercholesterolemia; metabolic syndrome; obesity with acanthosis nigricans; polycystic ovary syndrome.
ALL of the following
- a) At initiation of antiretroviral therapy (ART).
- b) At switch of ART.
- c) 3–6 months after starting or switching ART.
- d) Annually when initial screening results were normal.
For individuals with cystic fibrosis aged ≥10 without CFRD: annual screening for CFRD with an oral glucose tolerance test (OGTT) meets coverage criteria.
For overweight/obese individuals <18 years with risk factors: screening once every 3 years with fasting plasma glucose, OGTT, or hemoglobin A1c meets coverage criteria.
For pregnant individuals: a fasting plasma glucose test or an OGTT up to once per month during pregnancy meets coverage criteria; for those diagnosed with GDM, a 75-g OGTT meets coverage for 4–12 weeks postpartum screening for persistent diabetes or prediabetes and for confirmatory testing when initial postpartum screen is positive.
For individuals prescribed second‑generation antipsychotic medications: screening with fasting plasma glucose or hemoglobin A1c meets coverage criteria at initiation, 12–16 weeks after initiation (or sooner if clinically indicated), and annually while on treatment.
Exclusions
- Fasting plasma glucose testing at a wellness visit with no abnormal findings.
- Measurement of hemoglobin A1c in situations not previously described (see Note 2 for specific exclusions).
A1c-specific exclusions per Note 2
- To test for diabetes in individuals presenting with acute or persistent classic symptoms of diabetes mellitus.
- In pregnant individuals without an established diagnosis of diabetes or prediabetes.
- To screen for diabetes in individuals diagnosed with cystic fibrosis.
- In conjunction with measurement of fructosamine.
- In individuals with conditions associated with increased red blood cell turnover (e.g., sickle cell disease, HIV positive, receiving hemodialysis or erythropoietin therapy, recent blood loss or transfusion).
Notes: First‑degree relatives include parents, full siblings, and children; second‑degree relatives include grandparents, aunts/uncles, nieces/nephews, grandchildren, and half‑siblings.
ADA-based screening and testing criteria
ADA-recommended indications and intervals for diabetes screening and diagnostic testing as cited in the policy:
Consider testing asymptomatic adults who are overweight or obese (BMI ≥25 kg/m2 or ≥23 kg/m2 in Asian Americans) who have one or more risk factors: first‑degree relative with diabetes; high‑risk race/ethnicity; history of cardiovascular disease; hypertension (≥140/90 mmHg or on therapy); low HDL or high triglycerides; polycystic ovary syndrome; physical inactivity; or other clinical conditions associated with insulin resistance.
People with prediabetes (A1c ≥5.7%, impaired glucose tolerance, or impaired fasting glucose) should be tested yearly.
Individuals with prior gestational diabetes mellitus should have lifelong testing at least every three years.
Begin screening for all other patients at age 35; if results are normal, repeat at minimum every 3 years, with more frequent testing individualized based on risk status or changes in risk.
A1c may be used for diagnosis but must be performed with NGSP‑certified methods traceable to the DCCT reference assay; use plasma glucose criteria where A1c may be unreliable (hemoglobin variants, pregnancy 2nd/3rd trimesters and postpartum, G6PD deficiency, HIV, hemodialysis, recent transfusion, erythropoietin therapy).
Point‑of‑care A1c testing for screening/diagnosis is restricted to FDA‑approved devices in CLIA‑certified laboratories performing moderate‑complexity testing with trained personnel.
Marked discordance between A1c and repeat blood glucose values should prompt consideration of test interference or analytic problems and use of alternative diagnostic criteria.
Coverage and clinical criteria for diabetes testing and monitoring
Clinical recommendations and testing practices to guide diagnostic and monitoring testing for diabetes and related conditions.
Asymptomatic adults: use FPG, 2‑h OGTT, or A1c to screen; begin at age 35 and if normal repeat at minimum every 3 years (sooner if risk changes).
Adults with overweight/obesity: test (FPG, 2‑h OGTT, or A1c) when BMI ≥25 kg/m2 (≥23 in Asian Americans) plus ≥1 risk factor; repeat per risk and guideline intervals.
Children/adolescents: after onset of puberty or ≥10 years of age with BMI ≥85th percentile and ≥1 risk factor, screen with FPG, 2‑h OGTT, or A1c; repeat at minimum every 3 years if normal.
Cystic fibrosis: annual OGTT beginning at age 10 for those without CFRD; A1c is not recommended for screening due to low sensitivity though A1c ≥6.5% is consistent with diagnosis.
Pregnancy/GDM: early screening if risk factors and universal screening at 24–28 weeks for those not previously found to have diabetes; during pregnancy, fasting, preprandial, and postprandial glucose monitoring recommended and pregnancy A1c should be used as a secondary measure of glycemic control.
HIV: screen with FPG before ARV start, at switch, 3–6 months after start/switch, then annually if initial results normal; A1c may underestimate glycemia and is not recommended for diagnosis in people with HIV.
A1c interference: when conditions alter the A1c–glycemia relationship (hemoglobin variants, pregnancy, G6PD deficiency, HIV, hemodialysis, recent transfusion, erythropoietin therapy), use plasma glucose criteria for diagnosis.
Laboratory standards: A1c tests should be NGSP‑certified and DCCT‑traceable; POC A1c allowed only with FDA‑approved devices in CLIA‑certified labs with documented competency and proficiency testing.
Inpatient monitoring: perform an A1c if no result in prior 3 months for hospitalized people with diabetes or hyperglycemia; POC glucose monitoring before meals for eating patients and every 4–6 h for not eating patients; more frequent monitoring for IV insulin per ADA guidance.
Perioperative management: aim for A1c <8% for elective surgery if possible; hold metformin the day of surgery; discontinue SGLT2 inhibitors 3–4 days preoperatively; hold morning oral agents and adjust insulin dosing; monitor glucose every 2–4 h while NPO and dose short/rapid‑acting insulin as needed.
Screening and diagnosis criteria
Screening and diagnostic recommendations summarized from multiple guideline bodies.
Diabetes Canada: screen using FPG and/or A1c every 3 years in individuals ≥40 or at high risk; A1c ≥6.5% diagnoses diabetes; A1c testing frequency for most individuals approximately every 3 months when monitoring diabetes, and at least every 6 months when stable and meeting targets.
USPSTF: recommend screening for prediabetes and type 2 diabetes in adults aged 35–70 who are overweight or obese; screening tests include FPG, A1c, or OGTT; screening every 3 years may be reasonable for adults with normal glucose.
AACE: provides inclusion criteria for screening (age ≥45 without other risk factors; CVD or family history; overweight/obese; sedentary; at‑risk race/ethnicity; dyslipidemia; history of GDM; certain medications and conditions); recommends repeat testing at least every 3 years and consider annual screening for patients with two or more risk factors.
Monitoring and perioperative criteria
Monitoring, perioperative care, and special-population considerations.
KDIGO (CKD patients): use HbA1c to monitor diabetes in CKD patients twice yearly if stable and up to quarterly (4x/year) if targets unmet or therapy changed; individualize HbA1c targets from <6.5% to <8.0% in those with diabetes and CKD not on dialysis, and note A1c accuracy declines with advanced CKD and dialysis.
Perioperative goals and actions: preoperative risk assessment for high‑risk patients; A1c goal for elective surgery <8% when possible; perioperative blood glucose goal 100–180 mg/dL within 4 hours of surgery; hold metformin day of surgery; discontinue SGLT2 inhibitors 3–4 days prior; monitor glucose every 2–4 hours while NPO; adjust basal and bolus insulin dosing per guidance.
Hospitalized patients: perform A1c if no result available from prior 3 months; POC glucose monitoring before meals for eating patients and every 4–6 hours for non‑eating patients; more frequent monitoring required for safe IV insulin therapy.
Coverage stance and operational notes
Guideline-informed clinical context, regulatory notes, and billable codes relevant to diabetes testing are presented.
A1c testing and reporting: laboratories should use NGSP‑certified methods traceable to the DCCT reference assay; point‑of‑care A1c testing for screening/diagnosis limited to FDA‑approved devices used in CLIA‑certified labs of moderate complexity or higher by trained personnel.
Regulatory note: If this policy conflicts with applicable government coverage (e.g., LCDs, NCDs, or state Medicaid), the government policy takes precedence.
Laboratory‑developed tests (LDTs): LDTs are regulated under CLIA as high‑complexity tests and are not FDA‑approved or cleared; FDA clearance is not currently required for clinical use.
Benefit verification: application of coverage criteria depends on individual benefit coverage at time of request; consult Medicare/Medicaid regulations and state policies when applicable.
Coverage changes summary
Revision history reports specific coverage criteria changes; full criteria text not contained in this segment but updates include additions and removals as noted.
Effective 4/1/2025: additions to coverage criteria include CC2e — 'Quarterly for individuals who are pregnant.' and CC5i — 'For individuals with metabolic dysfunction‑associated steatotic liver disease (MASLD).', and removal of previous Note 1 regarding plasma glucose alone diagnosing diabetes in symptomatic patients; providers should consult the updated policy when seeking authorization or submitting claims.
Coding and Diagnostic Thresholds
Applicable CPT/HCPCS procedure codesCPT
| 82947 | Glucose; quantitative, blood (except reagent strip) |
| 82951 | Glucose; tolerance test (GTT), 3 specimens (includes glucose) |
| 82952 | Glucose; tolerance test, each additional beyond 3 specimens |
| 82985 | Glycated protein |
| 83036 | Hemoglobin; glycosylated (A1C) |
| 83037 | Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use |
A1c testing quality requirementsmixed
| No codes listed |
Test standards and certificationmixed
| No codes listed |
A1C and diagnostic criteria (narrative)mixed
| A1C diagnostic cutoff: A1C ≥6.5% referenced for diagnosis of diabetes; alternative diagnostic criteria include FPG ≥126 mg/dL and 2-h PG ≥200 mg/dL (OGTT). |
Applicable CPT/HCPCS codesCPT
| 82947 | Glucose; quantitative, blood (except reagent strip) |
| 82951 | Glucose; tolerance test (GTT), 3 specimens (includes glucose) |
| 82952 | Glucose; tolerance test, each additional beyond 3 specimens |
| 82985 | Glycated protein |
| 83036 | Hemoglobin; glycosylated (A1C) |
| 83037 | Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use |
References (coding-related)mixed
| No codes listed |
inv-14: Diagnostic thresholds — Diabetes
Diagnostic criteria (asymptomatic individuals)Fasting plasma glucose (FPG) ≥126 mg/dL OR two‑hour plasma glucose during 75‑g OGTT ≥200 mg/dL OR hemoglobin A1c (A1c) ≥6.5% establishes a diagnosis of diabetes.
Confirmatory testingWhen results are discordant or uncertainty exists, repeat testing or use a second abnormal test (A1c and plasma glucose) either from the same sample or on a different day may be required.
Context/usageFPG and OGTT are often used for diagnosis; A1c reflects average glycemia over ~8–12 weeks and is recommended for diagnosis, screening, and monitoring except where unreliable.
inv-15: Prediabetes ranges
Impaired fasting glucose (IFG)FPG 100–125 mg/dL indicates impaired fasting glucose (prediabetes).
Impaired glucose tolerance (IGT)Two‑hour plasma glucose during 75‑g OGTT 140–199 mg/dL indicates impaired glucose tolerance (prediabetes).
A1c prediabetes rangeA1c 5.7% to <6.5% denotes increased risk (prediabetes).
inv-16: A1c diagnostic thresholds referenced
A1c diagnostic cutoffA1c ≥6.5% is used as a diagnostic threshold for diabetes.
Reported study cut pointsStudies have reported alternative cut points (e.g., 5.8%, 5.9%, 6.0%) with differing sensitivity/specificity compared with the 6.5% threshold.
Test limitationsA1c may identify fewer individuals than glucose‑based criteria and can be affected by conditions altering red blood cell kinetics; use plasma glucose criteria when A1c unreliable.
inv-17: FPG diagnostic threshold
FPG diagnostic thresholdFPG ≥126 mg/dL (after ≥8 hours fasting) is diagnostic of diabetes in asymptomatic individuals.
Pediatric considerationsPediatric FPG thresholds and optimal mmol/L cut points have been studied (e.g., thresholds reported in mmol/L in pediatric research), and pediatric thresholds may differ from adult cut points.
OGTT relationWhen using OGTT as reference, FPG ≥126 mg/dL shows high specificity (>95%) but variable sensitivity (~50%).
inv-18: Pregnancy A1C target
Ideal pregnancy A1c targetA1c <6% (<42 mmol/mol) is ideal in pregnancy if achievable without significant hypoglycemia.
Relaxed target to avoid hypoglycemiaA1c goal may be relaxed to <7% (<53 mmol/mol) if needed to prevent hypoglycemia.
Monitoring frequency in pregnancyA1c may need more frequent monitoring during pregnancy (e.g., monthly) due to altered red blood cell turnover.
inv-19: Perioperative blood glucose goal
Perioperative glucose goalTarget blood glucose in the perioperative period: 100–180 mg/dL (5.6–10.0 mmol/L) within 4 hours of surgery.
Monitoring cadenceMonitor blood glucose at least every 2–4 hours when the individual is NPO; dose short/rapid‑acting insulin as needed.
Medication managementHold metformin on day of surgery; discontinue SGLT2 inhibitors 3–4 days preoperatively; adjust other oral agents and insulin dosing per guidance.
inv-20: Diagnostic thresholds (composite)
Composite diagnostic thresholdsDiagnostic criteria include: A1c ≥6.5%; FPG ≥126 mg/dL; 2‑hour OGTT ≥200 mg/dL; or random (nonfasting) plasma glucose ≥200 mg/dL with classic hyperglycemia symptoms.
Symptomatic confirmationA random PG ≥200 mg/dL in the presence of hyperglycemia symptoms confirms diabetes without additional testing.
Test selection noteFPG, 2‑h PG (OGTT), and A1c reflect different aspects of glycemia and identify different groups; OGTT diagnoses more people with prediabetes/diabetes compared with other tests.
inv-21: Perioperative glucose target
Perioperative glucose target (restated)Aim for perioperative blood glucose 100–180 mg/dL (5.6–10.0 mmol/L) within 4 hours of surgery.
Avoid overly strict goalsStricter perioperative glycemic goals (<80–180 mg/dL) are not advised due to lack of improved outcomes and increased hypoglycemia risk.
Preoperative A1c considerationA1c <8% is suggested for elective surgery when possible to reduce perioperative risk.
inv-22: HbA1c monitoring frequency (CKD patients)
CKD monitoring frequency — stable patientsMeasure HbA1c twice yearly (every 6 months) in patients with diabetes and CKD when stable and glycemic targets are met.
CKD monitoring frequency — unstable or therapy changesIncrease HbA1c testing up to quarterly (4 times per year) when glycemic targets are unmet or therapy has changed.
KDIGO individualized A1c targetKDIGO recommends individualized HbA1c targets ranging from <6.5% to <8.0% for patients with diabetes and CKD not treated with dialysis.
inv-23: Quarterly testing for pregnancy
Quarterly testing for pregnancy (policy change)Policy revision adds: 'Quarterly for individuals who are pregnant' as CC2e, indicating higher A1c testing frequency during pregnancy.
Pregnancy monitoring contextGuidance notes A1c may need more frequent monitoring (e.g., monthly) in pregnancy and OGTT is preferred postpartum (4–12 weeks).
Implication for coverageThis revision explicitly supports more frequent A1c testing for pregnant individuals under coverage criteria updates.
Provider Actions and Operational Notes
Documentation Required
Verify member benefits before requesting or billing tests
Application of coverage criteria depends on the member’s individual benefit coverage at the time of the request; specifications for Medicare and Medicaid are in the ‘Applicable State and Federal Regulations’ section and govern determinations for those programs.
Documentation Required
Perform A1c with NGSP‑certified methods; limit POC A1c to FDA‑approved CLIA settings
Use NGSP‑certified laboratory methods for A1c testing; point‑of‑care A1c testing for screening or diagnosis is restricted to FDA‑approved devices performed in CLIA‑certified laboratories of moderate complexity or higher by trained personnel.
- If marked discordance exists between A1c and repeat blood glucose, evaluate for test interference and consider plasma glucose criteria.
Documentation Required
Obtain inpatient A1c if no result within 3 months
If a person with diabetes or hyperglycemia is admitted and there is no A1c result available from the prior 3 months, perform an A1c test during the hospitalization.
Documentation Required
Manage diabetes medications and monitor glucose in the perioperative period
Follow perioperative medication and glucose‑monitoring actions: hold metformin the day of surgery; discontinue SGLT2 inhibitors 3–4 days before surgery; hold other oral agents the morning of surgery and adjust insulin dosing as recommended; monitor blood glucose every 2–4 hours when NPO and dose short/rapid‑acting insulin as needed.
- Aim for perioperative blood glucose ~100–180 mg/dL within 4 hours of surgery and consider A1c <8% for elective procedures when possible.
- Reduce basal insulin by ~25% the evening before surgery or adjust per clinical judgment/insulin type; use basal‑bolus regimens for noncardiac general surgery when indicated.
Note
Follow government (Medicare/Medicaid) coverage rules when they conflict
When this policy conflicts with an applicable government coverage determination (for example, LCDs, NCDs for Medicare, or state Medicaid rules), the government policy supersedes this policy for that member.
Documentation Required
Revision summary — material edits to coverage criteria
The revision history reflects material changes to coverage criteria: CC2 was expanded to add quarterly testing for pregnant individuals and CC5 was expanded to add coverage for individuals with MASLD; Note 1 was removed. Providers should consult the updated criteria when requesting authorization or submitting claims.
- Added CC2e: 'Quarterly for individuals who are pregnant.'
- Added CC5i: 'For individuals with metabolic dysfunction-associated steatotic liver disease (MASLD).'
- Removed Note 1 that previously stated plasma glucose alone can diagnose diabetes with classic symptoms.
Key Definitions and Terminology
inv-30: Selected terminology
A1cA1c = Glycated hemoglobin (measure of average glycemia).
FPGFPG = Fasting plasma glucose (glucose after ≥8 hours without caloric intake).
OGTTOGTT = Oral glucose tolerance test (typically 75‑g load with 2‑hour plasma glucose measurement).
MASLDMASLD = Metabolic dysfunction‑associated steatotic liver disease (hepatic fat accumulation associated with metabolic conditions).
inv-31: A1c (HbA1c) testing standard
NGSP certification requirementA1c testing should be performed using a method certified by the National Glycohemoglobin Standardization Program (NGSP) and traceable to the DCCT reference assay.
Reference standardMethods traceable to the DCCT reference assay ensure comparability of A1c results across laboratories.
Evidence citationADA guidance endorses NGSP certification for diagnostic and monitoring A1c use (American Diabetes Association Professional Practice Committee, 2023).
inv-32: Point-of-care (POC) A1c testing
POC A1c device restrictionPoint‑of‑care (POC) A1c testing for screening and diagnosis is restricted to FDA‑approved/cleared devices used in CLIA‑certified laboratories performing testing of moderate complexity or higher.
Personnel and quality requirementsSites must meet CLIA standards including documented personnel competency and participation in an approved proficiency testing program (typically three times per year).
LDT regulatory noteLaboratory‑developed tests (LDTs) are regulated as high‑complexity under CLIA '88 and are not FDA cleared; POC A1c use must follow FDA/CLIA requirements.
inv-33: NGSP certification statement
NGSP certification statementThe A1c test should be performed using a method certified by the NGSP and standardized or traceable to the DCCT reference assay.
POC assay certificationPOC A1c assays may be NGSP certified and FDA cleared for use in CLIA‑regulated settings, but must meet CLIA quality standards to be used for screening/diagnosis.
Quality standardsCLIA standards include personnel requirements, documented annual competency assessments, and approved proficiency testing participation.
inv-34: POC A1C constraints
POC A1c constraintsPOC A1c testing allowed only with FDA‑approved devices in CLIA‑certified laboratories that perform moderate‑complexity testing, with trained personnel and proficiency testing.
Annual competencyPersonnel performing POC testing require documented annual competency assessments per CLIA standards.
Proficiency testing frequencyParticipate in an approved proficiency testing program (typically three times per year) to meet CLIA quality requirements.
inv-35: T1D
Type 1 diabetes (T1D)T1D is characterized by marked insulin deficiency, presence of autoantibodies (e.g., GAD65, IA‑2), and requires immune marker evaluation to distinguish from other types.
Diagnosis considerationsAutoantibody testing and clinical presentation are used to confirm T1D and guide appropriate therapy, especially in children and young adults.
inv-36: T2D
Type 2 diabetes (T2D)T2D is characterized by progressive loss of β‑cell insulin secretion and variable insulin resistance; often asymptomatic and may remain undiagnosed for years.
Screening recommendationAll adults ≥35 years with risk factors should be screened for T2D; consider earlier/more frequent testing based on risk profile.
inv-37: GDM
Gestational diabetes mellitus (GDM)GDM is carbohydrate intolerance first recognized during pregnancy; screen all pregnant individuals at 24–28 weeks using a one‑ or two‑step approach.
Postpartum testingIndividuals with GDM should be tested at 4–12 weeks postpartum with a 75‑g OGTT using nonpregnancy criteria to detect persistent diabetes or prediabetes.
inv-38: Laboratory-developed test (LDT)
LDT regulatory classificationLaboratory‑developed tests (LDTs) are regulated by CMS as high‑complexity tests under CLIA '88.
FDA statusLDTs are not FDA‑approved or cleared for clinical use, and FDA clearance is not currently required for clinical use under existing practice described.
inv-39: MASLD
MASLD definitionMetabolic dysfunction‑associated steatotic liver disease (MASLD) denotes hepatic fat accumulation in people who consume little or no alcohol and is associated with conditions such as diabetes, obesity, hypertension, and hyperlipidemia.
Clinical associationMASLD is associated with increased risk for diabetes and cardiovascular disease and is noted as a population of interest in coverage updates.
inv-40: References
Evidence basePolicy updates are supported by an extensive evidence bibliography including guideline and research citations (e.g., ADA, KDIGO, WHO, multiple primary studies).
Select referencesRepresentative citations include Selvin (2022), van 't Riet et al. (2010), Mitsios et al. (2018), and WHO (2016).
Revision documentationRevision history (4/1/2025) documents literature review and changes to coverage criteria and references.
Policy Summary
PayerMolina Healthcare
PolicyDiabetes Mellitus Testing (A1c, FPG, OGTT) - Coverage and Payment
Policy CodePolicy G2006
Change TypeCriteria additions and removalreference updates
Effective DateApr 1, 2025
Last ReviewApr 1, 2025
Next Review DateApr 1, 2025
Key ActionVerify member benefits at time of request and consult updated criteria when seeking authorization or submitting claims.
SourceLink
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