Blood Glucose Monitors
Medicare will cover home blood glucose monitors for a patient that meets the following basic criteria:

• The patient has been diagnosed with diabetes (ICD-9 codes 250.00-250.93) which is being treated by a physician; and
• The glucose monitor and related accessories and supplies have been ordered by the physician who is treating the patient’s diabetes; and
• The patient (or patient’s caregiver) has successfully completed training or is scheduled to begin training on how to use a monitor, test strips, lancets, etc.; and
• The patient (or patient’s caregiver) is capable of using the test results to assure the patient’s appropriate glycemic control; and
• The device is designed for home use.

Test Strips and Lancets
For non-insulin dependent patients, Medicare will cover up to 100 test strips and 100 lancets every three months and one lancet device every six months. For insulin dependent patients, Medicare will cover up to 100 test strips and 100 lancets every month and one lancet device every six months. In both situations, the following criteria must be met:

• The patient has met the criteria for a blood glucose monitor; and
• The supplier of the test strips and lancets maintains in its records the order from the treating physician; and
• The beneficiary has used almost the entire supply of test strips and lancets that had been previously dispensed.

Medicare will only cover strips and lancets in an amount in excess of those listed above in the following circumstances:

• The treating physician has ordered a frequency of testing that exceeds the utilization guidelines and has documented in the patient’s medical record the specific reason for the additional strips for that particular patient; and
• The treating physician has seen the patient and has evaluated their diabetes control within six months prior to ordering quantities of strips and lancets that exceed the utilization guidelines; and
• If refills of quantities of supplies that exceed the utilization guidelines are dispensed, there must be documentation in the physician’s records (eg. A specific narrative statement that adequately documents the frequency at which the patient is actually testing or a copy of the beneficiary’s log) or in the supplier’s records (eg. A copy of the beneficiary’s log) that the patient is actually testing at a frequency that corroborates the quantity of supplies that have been dispensed. If the patient is regularly using quantities of supplies that exceed the utilization guidelines, new documentation must be present at least every six months.