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11/28/2023

CMS Changes Bring a Major Milestone for CGM Patients and Suppliers

CMS Changes Bring a Major Milestone for CGM Patients and Suppliers
CGM hme billing

The new 90-day bill has created a buzz among suppliers. Beginning January 1, 2024, the Centers for Medicare & Medicaid Services (CMS) will allow 90-day payment for both blood glucose monitor and continuous glucose monitor (CGM) supplies—a revolutionary development.

This change is going to simplify administrative tasks, help patients and HME/DME providers alike.

Overview of the Bill

The American Association for Homecare (AAHomecare) bill represents a turning point in the field of diabetes care. This law states to replace the current 30-day billing system for CGM and blood glucose monitor supplies with a 90-day billing cycle.

Why The Previous Process Was a Hassle?

The preceding 30-day billing system posed a significant administrative challenge for HME/DME providers by inundating suppliers with unnecessary paperwork. This system forced suppliers to navigate the intricate balance of timely patient supply management while aligning HME billing activities with a rigid monthly cycle for dispensed products. Consequently, the introduction of the 90-day billing cycle has emerged as an advantage for suppliers. Let’s delve into the advantages this new billing approach brings to our valued suppliers.

Streamlining Administrative Processes

The new CMS policy aims to simplify administrative procedures for CGM suppliers, and they can now file claims once per 90-day shipment, aligning the dispensing of the products to billing for them.

As a result, CGM patients receive the required diabetic testing supplies quickly. Moreover, they can continue to maintain consistent blood glucose control without having to worry about running out of testing supplies. This streamlines the patient-supplier relationship, ensuring that patients have the testing supplies they need without unnecessary friction from the suppliers due to billing bottlenecks.

Improved Care Delivery and Cost Savings

With the reduction in billing and administrative processes, the 90-day billing cycle will generate substantial cost reductions while making diabetic testing more accessible for patients.

Enhancing Patient Experience

Patients also benefit from a more reliable supply of necessary supplies, ensuring uninterrupted and efficient blood glucose management. This consistency is crucial for effective diabetes management, leading to better monitoring regimen adherence.

The Bottom Line

The CMS has approved a ninety-day bill for CGM supplies, a significant step forward for both patients and HME/DME Providers. This move reduces administrative complexities, streamlines processes, and improves patient experiences. This move signifies a shift towards a more patient-centric and cost-effective diabetes management approach.

Ashley Banks
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