reimbursement

Learn about the clinic reimbursement and coding process for the Dexcom G6 Pro CGM System.

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reimbursement & coding for Dexcom G6 Pro

Commercial health insurers and government-sponsored plans provide more coverage for continuous glucose monitoring (CGM) systems now than ever before. Many reimbursement challenges that early adopters of CGM faced have been eliminated, supporting a more favorable reimbursement environment overall.

Learn more about the reimbursement process for Dexcom G6 Pro in the videos below.

To see costs and to order Dexcom G6 Pro, please visit our distributor, GEMCO.

What CPT codes can be billed for professional CGM?

This video provides details on CPT codes 95250 and 95251, which are billable services for professional CGM.*

Video length: 1 min. 37 sec.

What CPT codes can be billed for Professional CGM

Can CPT codes 95249, 95250, and 95251 be denied?

This video explains the reasons that CPT codes may be denied during the billing process, as well as steps healthcare providers can take to prevent this outcome.*

Video length: 1 min. 20 sec.

Do services associated with CPT codes 95249 and 95250 need to be provided face-to-face?

This video explains why professional CGM services associated with these CPT codes must be provided face-to-face.*

Video length: 28 sec.

Do services associated with CPT codes 95249 and 95250 need to be provided face to face

Do services associated with CPT code 95251 need to be provided face-to-face?

This video explains why professional CGM services associated with this CPT code may be provided face-to-face or remotely.*

Video length: 41 sec.

Do services associated with CPT code 95251 need to be provided face to face

Who can perform and bill CPT codes 95249 and 95250?

This video provides information on which types of healthcare providers are approved to perform and bill professional CGM services associated with these CPT codes.*

Video length: 1 min.

Who can perform and bill CPT code 95249 and 95250

Who can perform and bill CPT code 95251?

This video provides information on which types of healthcare providers are approved to perform and bill professional CGM services associated with this CPT code.*

Video length: 26 sec.

What is the typical amount reimbursed for training on a personal CGM system, professional CGM system, and interpretation?

This video provides detailed information on how a physician’s fee schedule, payer type, and other factors can influence the reimbursement amounts for training and interpretation services associated with Dexcom G6 Pro.*

Video length: 1 min. 11 sec.

Which insurance companies are paying for CPT codes 95249, 95250, and 95251? How do healthcare providers find out the specifics of each insurance company’s CGM coverage policy and criteria?

This video provides an in-depth overview about insurance companies’ CGM coverage policies and criteria, as they pertain to use of Dexcom G6 Pro.*

Video length: 1 min. 13 sec.

Which insurance companies are paying for CPT codes 95249, 95250 and 95251

Code	Description	Details
95250	Startup and training of a professional CGM (sensor placement, patient training, sensor removal, printout of recording).	Code is typically billed after patient has had sensor removed and when the CGM system is returned to the office by the patient.
95251	Analysis, interpretation, and recording of a professional CGM.	Code can only be billed a maximum of once a month. There must be a minimum of 72 hours of CGM data printed from the device that the patient was trained on in order to bill.

*The reimbursement information provided is intended to assist you with billing for your services related to continuous glucose monitoring (CGM). It is intended for informational purposes only and is not a guarantee of coverage and payment. Providers are encouraged to contact their local payers with questions related to coverage, coding and payment. Rates provided under the Medicare PFS and OPPS are rounded to the nearest hundredth.

Training & Resources

Access tutorial videos and step-by-step instructions on how to use Dexcom G6 Pro.

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Frequently Asked Questions

Find the answers to frequently asked questions about Dexcom G6 Pro.

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Contact Us

If you are a healthcare provider and want to learn more about Dexcom, please fill out the form and a representative will contact you. If you are a Dexcom User or Patient, please contact Dexcom here.

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Request a G7 Sample

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Please note: To ensure a successful transaction, please provide information that matches the Provider’s medical license information. A valid business address is required for a request to be fulfilled.

Do not include prefix (Mr., Mrs., Dr.)

As listed on Provider’s medical license (no MD, Jr., Sr.)

Please use the Provider's NPI

Is your patient on a connected pump device?

Yes

By submitting the above form, I certify that I am a licensed practitioner, authorized to receive and dispense samples of the Dexcom G6 Continuous Glucose Monitoring System and/or Dexcom‘s next generation product, Dexcom G7 (the "Samples"). I represent that I am requesting the Samples for evaluation purposes and that I will not (i) sell, resell, barter, return for credit or seek reimbursement for the use of the Samples, or (ii) for professional services for dispensing or evaluating the Samples, I also agree to inform my patients that they should not submit claims for reimbursement to any third party for any Samples.

The Samples are FDA cleared for use with a compatible smart device or separate piece of durable medical equipment called a receiver. Neither devices nor receivers are included in the Samples. Accordingly, and in light of the applicable G6 or G7 Dexcom Instructions for Use, you should dispense Samples only to a patient who (or whose authorized caregiver), in the exercise of your clinical judgment, (i) has reliable access to a compatible smart device and/or automated insulin delivery system, and (ii) is capable of safely using the Samples with their smart device, without the need for a separate dedicated receiver.

Please note that Medicare will reimburse for sensors only if the beneficiary also uses a receiver covered by Medicare. Accordingly, it is appropriate to give Samples to Medicare patients only if they have (in the case of the G6 Samples) or would be eligible to obtain (in the case of the G7 Samples), a Medicare-covered receiver.

You agree that you will not provide the Samples to any patients that are beneficiaries under the Maine or Colorado state Medicaid programs. I understand that Dexcom will be tracking, and if necessary, reporting and may be subject to disclosure requirements with respect to the provision of these Samples. I agree not to reuse any Samples. I acknowledge that Dexcom provides no warranties for the Samples other than the warranties outlined in the applicable Dexcom Instructions for Use. I will comply with all applicable federal, state and local laws in receiving and dispensing these Samples, and I agree to store and use these Samples in a manner consistent with the applicable Dexcom Instructions for Use. Dexcom is a registered trademark of Dexcom, Inc. in the United States and/or other countries. ©2023 Dexcom, Inc. All rights reserved.

LBL-1004145 Rev001

By submitting the above form, I certify that I am a licensed practitioner, authorized to receive and dispense these Dexcom G6 Continuous Glucose Monitoring Systems and/or Dexcom‘s next generation product, Dexcom G7 (the "Dexcom Education Devices") which are provided in the quantities listed above.

The Dexcom Education Devices are FDA cleared for use with a compatible smart device or separate piece of durable medical equipment called a receiver. Neither smart devices nor receivers are included with the Dexcom Education Devices. I understand that these Dexcom Education Devices are being requested for me and other healthcare professionals ("HCPs") for evaluation purposes to learn more about the Dexcom Education Devices and experience the benefits of the Dexcom Education Devices through a product demonstration, and that each HCP will need a compatible smart device for the product demonstration.

I acknowledge that Dexcom provides no warranties for the Dexcom Education Devices other than the warranties outlined in the applicable Dexcom Instructions for Use. I will comply with all applicable federal, state and local laws in receiving and dispensing these Dexcom Education Devices in a manner consistent with the applicable Dexcom Instructions for Use, and agree not to reuse any Dexcom Education Devices. I agree to receive, store, distribute, and/or use these Dexcom Education Devices in a manner consistent with the applicable Dexcom Instructions for Use and device labeling. I understand that Dexcom will be tracking, and if necessary, reporting and may be subject to disclosure requirements with respect to the provision of these Dexcom Education Devices. I understand and agree to properly dispose of the Dexcom Education Devices immediately following the completion of the product demonstration. The Dexcom Education Devices are being provided at no cost, without any expectation of remuneration, HCPs have no obligations under the federal supply schedule contract for participating in the product demonstration, and Dexcom waives any rights under this contract or applicable law to pursue a claim for the costs associated with the Dexcom Education Devices.

Dexcom is a registered trademark of Dexcom, Inc. in the United States and/or other countries. ©2023 Dexcom, Inc. All rights reserved.

By choosing to request info, you are granting Dexcom, Inc. permission to process your personal information to send you additional information and promotional communications related to Dexcom products. You may opt-out of these communications at any time. Dexcom respects the privacy and confidentiality of your personal information. The information you provide will be sent securely and subject to the Dexcom Terms of Use and Privacy Policy.