Continuous Glucose Monitoring and Insulin Delivery for Managing Diabetes (for Idaho Only)
Idaho-specific UnitedHealthcare medical policy (CS024ID.B) governing coverage and medical necessity criteria for continuous glucose monitoring (CGM) devices including implantable long-term sensors and insulin delivery devices; references Idaho Medicaid handbook and DME MAC LCD L33822 for state-specific criteria.
Added instruction to refer to the Idaho Medicaid Provider Handbook, Suppliers, Chapter 5.25 for medical necessity clinical coverage criteria for insulin infusion pumps.
Added instruction to refer to the DME MAC LCD for Glucose Monitors (L33822) for medical necessity coverage criteria for short-term and long-term CGM.
Removed language indicating coverage criteria must be met for prior authorization or contracted supplier and removed specified authorization durations (initial up to 6 months; reauthorization up to 12 months).
Removed multiple specific clinical coverage criteria and continued-use criteria for long-term CGM, including criteria for nonintensive insulin-treated individuals with hypoglycemia history.
Removed reference to InterQual® CP as the source for medical necessity clinical coverage criteria.
Updated Description of Services, Clinical Evidence, and References sections to reflect the most current information.
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.