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Dexcom G5 CGM System is now covered under Medicare

 

Dexcom G5 Continuous Glucose Monitoring (CGM) System is now covered under Medicare for all people with diabetes on intensive insulin therapy who meet the eligibility criteria.

 

Dexcom is pleased to announce that the U.S. Centers for Medicare & Medicaid Services (CMS) is now covering the Dexcom G5 CGM System. People covered by Medicare who have either Type 1 or Type 2 diabetes, intensively manage their insulin and meet the eligibility criteria will now be able to obtain reimbursement. 1

Who is covered under Medicare?

According to CMS, therapeutic CGM may be covered by Medicare when all of the following criteria are met:

  • The beneficiary has diabetes mellitus; and,
  • The beneficiary has been using a home blood glucose monitor (BGM) and performing frequent (four or more times a day) BGM testing; and,
  • The beneficiary is insulin-treated with 3 or more daily injections (MDI) of insulin or a continuous subcutaneous insulin infusion (CSII) pump; and,
  • The beneficiary's insulin treatment regimen requires frequent adjustments by the beneficiary on the basis of therapeutic CGM testing results.
  • Within six (6) months prior to ordering the CGM, the beneficiary had an in-person visit with the treating practitioner to evaluate their diabetes control and determine that the above criteria are met; and,
  • Every six (6) months following the initial prescription of the CGM, the beneficiary has an in-person visit with the treating practitioner to assess adherence to their CGM regimen and diabetes treatment plan.

In order to be included in this category, the system must be defined as therapeutic CGM, meaning you can make treatment decisions using the device. Dexcom G5 CGM System is the only system approved by the FDA to meet that criteria.

Note: Under the current ruling, the beneficiary may NOT use their smart phone to display glucose data and still be eligible for reimbursement for the purchase of a therapeutic CGM: you cannot use the Dexcom CGM app to display glucose data and be eligible for reimbursement from Medicare.

How it works

Monitor glucose activity in real-time with a small sensor, transmitter and a Dexcom Receiver. Receive glucose readings every 5 minutes.

Take Control

Take control with Dexcom G5 CGM System and stay one step ahead of diabetes. Receive high/low glucose alerts and alarms. 

Most Recommended CGM

The Dexcom G5 CGM System is the most recommended CGM on the market2, and is the only CGM system approved for adults and pediatric patients two years of age and older3.

Take the next step with Dexcom

If you are ready to get started with Dexcom G5 CGM System, the process is simple. Begin by providing us with a bit of information below, and we will follow up with you to take the next step. If you are ready to get started and would prefer to talk to a representative, please call us at 888.738.3646.

Patient Information
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Diabetes therapy
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By submitting this form, you agree to the Dexcom Terms of Use and Privacy Policy, and agree that we may use information you provide us to communicate with you in accordance with those terms.

In addition, by checking the applicable box(es) below, you are agreeing to receive at the phone number set forth above, automated phone call and/or text communications, including pre-recorded and auto-dialed communications from or on behalf of Dexcom, Inc. ("Dexcom") concerning the marketing and sale of Dexcom’s products and services: you certify that a) you are the account holder and consent to enroll or have the account holder's consent to enroll and b) you are age 18 or older. Your service provider's airtime, message, and data rates may apply. Your consent is not required for purchase. You may opt out at any time by texting "STOP" in return to a text, calling Dexcom at 888-738-3646 or sending an email to privacy@dexcom.com.

 

*Click here for full Medicare decision coverage 

1 The beneficiary may NOT use their phone or smart device for display of Continuous Glucose Monitoring (CGM) data and still be eligible for reimbursement by Medicare for Therapeutic CGM.
2 dQ&A market research study, 2016 by CGM users
3 Dexcom G5 Mobile user guide, 2017

BRIEF SAFETY STATEMENT The Dexcom G5 Mobile Continuous Glucose Monitoring (CGM) System ("G5") is a glucose monitoring system indicated for the management of diabetes in persons age 2 years and older. The G5 is designed to replace fingerstick blood glucose testing for diabetes treatment decisions. The G5 also aids in the detection of episodes of hyperglycemia and hypoglycemia. The G5 is intended for single patient use and requires a prescription. CONTRAINDICATIONS Do not rely on the G5 CGM data if you have recently taken acetaminophen. Remove the G5 (sensor, transmitter, and receiver) before Magnetic Resonance Imaging (MRI), Computed Tomography (CT) scan, or high-frequency electrical heat (diathermy) treatment. The G5 is MR Unsafe. Do not bring any portion of the G5 into the MRI environment. WARNING CGM-based diabetes treatment decisions are only approved with the G5, not previous generations of Dexcom CGM systems. Calibrate at least once every 12 hours using a fingerstick. If your G5 does not display a sensor glucose reading and an arrow, or if you are getting inaccurate or inconsistent readings, take a fingerstick. If your glucose readings and alerts do not match your symptoms or expectations, take a fingerstick to confirm. Failure to do so may lead to hyperglycemia or hypoglycemia. The G5 is not approved for use in pregnant women, persons on dialysis or critically ill persons. If a sensor breaks and no portion of it is visible above the skin, do not attempt to remove it. Seek professional medical help if you have infection or inflammation on or near the sensor insertion point. Report broken sensors to Dexcom Technical Support. Sensor placement is not approved for sites other than under the skin of the belly (ages 2 years and older) or upper buttocks (ages 2-17 years). To “share” data, you need an internet connection and a separate compatible smart device running the Dexcom Follow App. Contact Dexcom Toll Free at 877-339-2664 or www.dexcom.com for detailed indications for use and safety information.

 

© 2017 Dexcom Inc. All rights reserved. This product is covered by U.S. patent.