Updates for Mayo Medical Plan diabetic members

Medica implements new protocol for CGMs

Effective Oct. 1, 2025, Medica is adding a new protocol regarding billing for continuous glucose monitors (CGMs) reported by a durable medical equipment (DME) provider. For dates of service on or after Oct. 1, 2025, CGM claims for Medica’s Mayo Medical Plan members reported by a DME provider require a national drug code (NDC) submitted with the appropriate HCSPCS code.

UnitedHealthcare manages claims outside of the Medica service area and will follow the updated CGM billing effective Jan. 1, 2026. This new protocol applies solely to Medica’s Mayo Medical Plan members.

Reporting of the appropriate NDC number will ensure that claims for CGM systems are processed under the correct benefit.

Products reimbursed under medical benefit:

- Eversense             - Guardian Connect

 Products reimbursed under pharmacy benefit:

- Dexcom                 - FreeStyle Libre