Date
Updates to Coverage of Continuous Glucose Monitors (CGMs):
Effective August 29, 2024, MO HealthNet will expand coverage of Continuous Glucose Monitors (CGMs) to participants currently diagnosed with Gestational Diabetes allowing this vulnerable population to obtain a CGM without a prior authorization. Claims for a CGM will auto-approve if the participant has had a gestational diabetes diagnosis billed to MO HealthNet recently OR if the pharmacy submits the appropriate gestational diabetes diagnosis code with the claim.
As a reminder, any MO HealthNet participant who currently utilizes insulin can also obtain a CGM without a prior authorization.
See the edit for more details: Continuous Glucose Monitors (CGMs) Clinical Edit | mydss.mo.gov