Continuous glucose monitoring devices (FreeStyle Libre and Dexcom)
Defines medical necessity, quantity limits, and coverage criteria for FreeStyle Libre readers/sensors and Dexcom receivers/transmitters/sensors for members of Neighborhood Health Plan of Rhode Island.
No material clinical or coverage changes in this revision.
Coverage Criteria for Continuous Glucose Monitors
Medical necessity for CGM coverage
Covered when ALL of the following are met:
Required medical information per policy
Coding logic for step therapy
Quantity limits
When covered, supply limits apply as follows
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.