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Diabetic Supply Updates for the CSHCN Services Program Effective April 1, 2025

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Effective for dates of service on or after April 1, 2025, quantity limitations for some diabetic supplies will change for the Children with Special Health Care Needs (CSHCN) Services Program.

When diabetic supply procedure codes A4253, A4259, and A9275 are submitted with modifier U9, indicating that the client is insulin-dependent, the limitations will increase as follows:

Procedure CodesNew Limitations
A4253, A9275Combined total of four units per month, any provider
A4259Two boxes per month, any provider

Self blood glucose monitoring (SBGM) is used as a supplement to continuous glucose monitor (CGM) devices. The reduced annual allowance for SBGM supplies billed in addition to an approved CGM system will increase as follows:

Procedure CodesNew Limitations
A4253Four boxes per calendar year, any provider
A4259Two boxes per calendar year, any provider

For more information, call the TMHP-CSHCN Services Program Contact Center at 800-568-2413.