Products & Programs PharmacyHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsNovember 8, 2023

Continuous glucose monitoring system — update

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

This article was originally published in September 2023 but now contains updated information as HCPCS codes, A4238, A4239, E2102, and E2103 will not be available until 2024.

On November 1, 2023, HealthKeepers, Inc. will implement a change regarding continuous glucose monitoring systems (CGMs). Previously, members could 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, and once added to the Virginia Medicaid Fee Schedule HCPCS codes: 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. Additionally, once added to the Virginia Medicaid Fee Schedule, select CGM access (including HCPCS codes A4238 and E2102) will 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 a separate company providing utilization management services on behalf of the health plan.

HealthKeepers, Inc. is an independent licensee of the Blue Cross Blue Shield Association. Anthem HealthKeepers Plus, offered by HealthKeepers, Inc., is a health plan that contracts with the Virginia Department of Medical Assistance Services to provide Medicaid benefits to enrollees. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

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PUBLICATIONS: December 2023 Provider Newsletter