State of Alabama
09/26/2025 | Press release | Distributed by Public on 09/26/2025 10:48
Continuous Glucose Monitor Policy Updates
TO: All Providers
RE: Continuous Glucose Monitor Policy Updates
Effective October 1, 2025, Continuous Glucose Monitors (CGMs) will be covered with prior authorization (PA) for recipients (children and adults) with one of the following:
- type 1 diabetes mellitus
- type 2 diabetes mellitus AND are insulin treated with multiple (three or more) daily injections of insulin
NOTE: Please review the full coverage criteria located on the durable medical equipment (DME) webpage at https://medicaid.alabama.gov/content/4.0_Programs/4.3_Pharmacy-DME/4.3.17_CGM.aspx.
An updated checklist will also be available on the DME webpage https://medicaid.alabama.gov/content/4.0_Programs/4.3_Pharmacy-DME/4.3.16_DME_PA_Checklists.aspx.
The Provider Billing Manual will be updated with the new criteria as soon as possible. Policy questions concerning this ALERT should be directed to the DME Program at (334) 242-5050.
The Current Procedural Terminology (CPT) and Current Dental Terminology (CDT) codes descriptors, and other data are copyright © 20 25 American Medical Association and © 20 25 American Dental Association (or such other date publication of CPT and CDT). All rights reserved. Applicable FARS/DFARS apply.
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