TABLE 4.

Work Breakdown for CGM CPT Codes

CodeWorkflowMay Be Performed by:*Face-to-Face Meeting Required?
95250: CGM placement, training, downloading, and report generationSensor insertionPhysician, nurse practitioner, or physician’s assistant or licensed staff within scope of practice or under direct supervision of providerYes
Patient trainingYes
Meter instructionYes
Removal of transmitterYes
Downloading of dataNo
Entering blood glucose readingsNo
Generating printed reportsNo
95251: interpretation of CGM dataProvider analysis of reportsPhysician, nurse practitioner, or physician’s assistantNo
  • * Staff may provide services if they meet the Medicare “incident to” rules for reimbursement of services rendered incident to a physician’s professional services.