Products & Programs PharmacyHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsAugust 11, 2023

Continuous glucose monitoring system

Please note, this communication applies to Anthem HealthKeepers Plus Medicaid products offered by HealthKeepers, Inc.

On November 1, 2023, HealthKeepers, Inc. will implement a change regarding continuous glucose monitoring systems (CGMs). Previously, we made it more convenient for members to obtain CGMs (devices and supplies) at their preferred in-network retail pharmacy or the CarelonRx, Inc. home delivery pharmacy. Beginning on November 1, 2023, CGM access, including HCPCS codes: A9276, A9277, A9278, A4239, and E2103 will only be available to a member through their in-network retail pharmacy or CarelonRx home delivery pharmacy and no longer a durable medical equipment (DME) provider. Select CGM access, including HCPCS codes A4238 and E2102 will continue to be available on the DME benefit. Members receiving CGMs and their prescribers have been/will be notified of the change.   

Note: This change only applies to CGMs and not insulin pump delivery systems.  

If you have any questions about this communication, call Anthem HealthKeepers Plus Provider Services at 800-901-0020.

*CarelonRx, Inc. is an independent company providing pharmacy benefit management services on behalf of the health plan.

VABCBS-CD-026618-23

PUBLICATIONS: September 2023 Provider Newsletter