Effective September 1, 2026, Independence Blue Cross (IBX) and Independence Administrators will reimburse durable medical equipment (DME) providers only for continuous glucose monitor (CGM) supply codes that meet the IBX definition of DME for Commercial members.
What changed?
CGM systems that only transmit data to a smartphone and do not include a stand-alone receiver or insulin pump integration are not considered DME.
The following daily supply codes for non-DME CGM systems are no longer covered under the medical benefit:
A9276
| Sensor;
invasive (e.g., subcutaneous), disposable, for use with non-durable medical
equipment interstitial continuous glucose monitoring system, one unit = 1 day
supply
|
A9277
| Transmitter;
external, for use with non-durable medical equipment interstitial continuous
glucose monitoring system
|
A9278
| Receiver
(monitor); external, for use with non-durable medical equipment interstitial
continuous glucose monitoring system
|
IBX reimburses DME providers for the following monthly supply codes for CGMs that meet the definition of DME:
A4238
| Supply
allowance for adjunctive, non-implanted continuous glucose monitor (cgm),
includes all supplies and accessories, 1 month supply = 1 unit of service
|
A4239
| Supply
allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm),
includes all supplies and accessories, 1 month supply = 1 unit of service
|
What DME providers should do
To access the most updated version of any active policy, please refer to the Medical and Claim Payment Policy Portal or simply navigate to the Commercial or Medicare Advantage policy bulletins.
26-0175