Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details.
This is a correction to the current Texas Medicaid Provider Procedures Manual, Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook, subsection 184.108.40.206, “Blood Glucose Monitors.” Currently, this subsection incorrectly lists the length of time the Continuous Glucose Monitoring device (CGM) is worn. The language will be updated with the February 2019 release. Below is the correct statement:
A CGM device is worn a minimum of 72 hours for the diagnostic purpose of collecting continuous blood sugar reading.
For more information, call the TMHP Contact Center at 800-925-9126.