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KMAP BULLETIN: Adjunctive Subcutaneous Continuous Glucose Monitors

Date: 02/27/24

KMAP GENERAL BULLETIN 24036 (PDF)

Effective with dates of service on and after April 1, 2024, adjunctive subcutaneous continuous glucose monitors (CGM) will be covered under the Durable Medical Equipment (DME) benefit.

The following HCPCS codes will be reimbursed for adjunctive CGMs:

Code, Rate, Max Units/Frequency

  • E2102 - $178.56, 1 unit per 12 months
  • A4238 - $209.56, 1 unit per month

Note: Other CGM requirements and limitations will remain same. Providers may choose adjunctive devices or non-adjunctive devices, but only one device per coverage period. The DME supplier is required to obtain a renewal order from the treating physician every 12 months.

Note: The rates noted in this bulletin are subject to future changes. Providers should check the Kansas Medical Assistance Program (KMAP) website for the most up-to-date rates.

Note: The effective date of the policy is April 1, 2024. The implementation of State policy by the KanCare Managed Care Organizations (MCOs) may vary from the date noted in the KMAP bulletins. The KanCare Open Claims Resolution Log on the KMAP Bulletins page documents the MCO system status for policy implementation and any associated reprocessing completion dates once the policy is implemented.

For the changes resulting from this provider bulletin, view the updated DME/Medical Supply Dealer Fee-for-Service Provider Manual, Section 8410, page 8-44; and the Professional Fee-for-Service Provider Manual, Section 8400,  page 8-75.