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Submitted by elaine.shi on
Coverage

Current patients may be eligible to receive ADP coverage for the sensors and transmitters used with their current rtCGM system if they meet all of the following:

  • use a rtCGM covered by the ADP;
  • are under the supervision or care of an ADP-registered DEP; and,
  • a physician or nurse practitioner, registered with the ADP-registered DEP as a prescriber, confirms that prior to starting real time continuous glucose monitoring, they met the device-specific Medical Eligibility Criteria.

If your patient meets the criteria listed above, an ADP Application Form may be submitted on their behalf. When completing the application, it may be necessary to answer ‘No’ to the questions in section 2a/2b. In such circumstances, it is recommended to complete a rtCGM Funding Exception Request Form (click to view sample) and submit it along with the ADP Application Form.

Coverage Category