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CPT code 95249: CGM setup, patient-provided equipment2026 Medicare rate & RVUs in Miami, FL

Reports setup and patient training for a personal continuous glucose monitor, including sensor placement and device preparation for at least 72 hours of monitoring.

CMS RVU26DEffective Oct 1, 2026One payment locality19.8K Medicare services in 2024

In Miami, FL, Medicare pays $74.66 for 95249 in the office.

$74.66Office (non-facility)
Not available in this settingHospital or facility
+6.9%vs the national office rate ($69.81)

Check a contract rate as a % of Medicare · 95249 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 95249 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Miami, FL
  2. What 95249 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 95249 covers

This service covers clinic setup and training for a continuous glucose monitor the patient supplies. Staff prepare the device, place and connect the sensor, calibrate the monitor as needed, teach the patient how to use it, and provide a data printout. It is used for patients with diabetes who are starting or receiving instruction on personal CGM equipment, commonly in endocrinology or diabetes-care practices.

Report 95249 when the patient’s own equipment is used and the monitoring period meets the 72-hour minimum. Documentation should support the patient-provided device, sensor setup, training performed, monitoring duration, and resulting printout. CMS identifies this as a technical-component-only service; report the separate interpretation code when analysis and a report are performed. Do not use this setup code for clinic-provided equipment, which is described by 95250.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Miami, FL compares for 95249

Across 109 of 109 payment localities, the office rate for 95249 runs from $59.51 in Arkansas to $99.45 in San Benito County, CA. Miami, FL pays $74.66. The RVUs are the same everywhere; the geographic indexes change the dollars.

95249 in Miami, FL vs other payment areas
  1. Miami, FL · this page$74.66
  2. Fort Lauderdale, FL · Florida$71.78−$2.88
  3. Rest of Florida · Florida$67.47−$7.19
  4. Los Angeles, CA · California$81.89+$7.23
  5. Washington, DC area · District of Columbia$82.15+$7.49
  6. Chicago, IL · Illinois$71.88−$2.78
  7. Manhattan, NY · New York$81.68+$7.02

Other areas in Florida first, then benchmark localities. Bars start at $0.

Every other payment area

95249 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$73.66—
AlabamaAlabama$60.67—
ArkansasArkansas$59.51—
ArizonaArizona$67.49—
Bakersfield, CACalifornia$75.86—
Chico, CACalifornia$75.76—
El Centro, CACalifornia$75.77—
Fresno, CACalifornia$75.76—

95249 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$59.51

$87.61

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
95249 office rate range by state
State / territoryOffice rate rangeLocalities
AK$73.661
AL$60.671
AR$59.511
AZ$67.491
CA$75.76–$99.4529
CO$73.901
CT$75.361
DC$82.151
DE$68.851
FL$67.47–$74.663
GA$62.67–$71.172
GU$78.631
HI$78.631
IA$63.181
ID$63.631
IL$64.60–$72.694
IN$64.121
KS$62.571
KY$62.091
LA$61.88–$65.952
MA$73.17–$82.942
MD$70.52–$82.153
ME$63.83–$68.702
MI$64.02–$68.332
MN$70.851
MO$60.32–$66.523
MS$59.941
MT$69.811
NC$64.741
ND$69.011
NE$63.701
NH$72.451
NJ$76.24–$80.852
NM$64.391
NV$69.651
NY$65.99–$83.895
OH$63.861
OK$62.181
OR$69.14–$77.072
PA$64.12–$72.872
PR$70.541
RI$71.921
SC$64.401
SD$68.921
TN$62.961
TX$63.55–$73.638
UT$65.561
VA$68.25–$82.152
VI$70.541
VT$68.461
WA$73.12–$85.112
WI$66.011
WV$61.411
WY$69.461

See 95249 in every payment locality

How the 95249 rate is calculated

Each of 95249’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 95249

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense2.05

2.05 RVUs× 1.000 GPCI

Malpractice0.04

0.04 RVUs× 1.000 GPCI

Adjusted RVUs

2.0900

Conversion factor

$33.4009

Medicare rate

$69.81

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Miami, FL inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,491

Code
95249
Physician work
0.00
Practice expense
2.05
Malpractice
0.04

GPCI2026.csv

42

Locality
Miami, FL
Physician work
1.000
Practice expense
1.041
Malpractice
2.529
Office calculation for 95249 in Miami, FL
ComponentRVULocality factorAdjusted
Physician work0.00× 1.0000.0000
Practice expense2.05× 1.0412.1340
Malpractice0.04× 2.5290.1012
Total RVUs2.2352
Conversion factor× 33.4009

Office rate, Miami, FL$74.66

Office: (0 × 1 + 2.05 × 1.041 + 0.04 × 2.529) × $33.4009 = $74.66

Open 95249 in the RVU calculator

Payment rules and modifiers for 95249

The CMS indicators that decide how 95249 is paid alongside other services.

CMS payment indicators · 95249

CGM setup, patient-provided equipment

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical3Technical component only.

Codes related to 95249

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 95249
CodeHow it relatesOffice range, Miami, FL
Used instead
95250CGM setup, practice-supplied equipmentProfessional or qualified health professional-provided equipment, rather than the patient’s own CGM equipment.$161.39
Often billed with
95251CGM interpretation, analysis, interpretation, and reportSeparate code for CGM analysis, interpretation, and reporting when those services are performed.$38.06
82947Blood glucose, quantitative, not reagent stripQuantitative blood glucose testing may be performed separately during a CGM-related encounter.$3.93

How 95249 has changed in Miami, FL

95249 · Office / nonfacility

$74.66

Effective 2026-10-01

The base rate is $6.98 higher than on 2025-10-01, moving from $67.68 to $74.66 (10.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $67.68changed to$74.66

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.94 changed to 2.05
    • Practice expense GPCI 1.027 changed to 1.041
    • Malpractice GPCI 2.500 changed to 2.529

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $68.97changed to$67.68

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.92 changed to 1.94

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $67.84changed to$68.97

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $65.30changed to$67.84

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.78 changed to 1.92
    • Practice expense GPCI 1.025 changed to 1.027
    • Malpractice GPCI 2.564 changed to 2.500

  5. January 1, 2023

    RVU23A

    $63.47changed to$65.30

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.69 changed to 1.78
    • Practice expense GPCI 1.023 changed to 1.025
    • Malpractice GPCI 2.629 changed to 2.564

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $62.21changed to$63.47

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.64 changed to 1.69

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $58.72changed to$62.21

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.51 changed to 1.64
    • Malpractice RVU 0.03 changed to 0.04
    • Practice expense GPCI 1.026 changed to 1.023
    • Malpractice GPCI 2.598 changed to 2.629

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $59.51changed to$58.72

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.53 changed to 1.51
    • Practice expense GPCI 1.029 changed to 1.026
    • Malpractice GPCI 2.566 changed to 2.598

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $59.45changed to$59.51

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    No ratechanged to$59.45

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$74.66Not available in this settingRVU26D
2026-07-01$74.66Not available in this settingRVU26C
2026-04-01$74.66Not available in this settingRVU26B
2026-01-01$74.66Not available in this settingRVU26A
2025-10-01$67.68Not available in this settingRVU25D
2025-07-01$67.68Not available in this settingRVU25C
2025-04-01$67.68Not available in this settingRVU25B
2025-01-01$67.68Not available in this settingRVU25A
2024-10-01$68.97Not available in this settingRVU24D
2024-07-01$68.97Not available in this settingRVU24C
2024-04-01$68.97Not available in this settingRVU24B
2024-03-09$68.97Not available in this settingRVU24AR
2024-01-01$67.84Not available in this settingRVU24A
2023-10-01$65.30Not available in this settingRVU23D
2023-07-01$65.30Not available in this settingRVU23C
2023-04-01$65.30Not available in this settingRVU23B
2023-01-01$65.30Not available in this settingRVU23A
2022-10-01$63.47Not available in this settingRVU22D
2022-07-01$63.47Not available in this settingRVU22C
2022-04-01$63.47Not available in this settingRVU22B
2022-01-01$63.47Not available in this settingRVU22A
2021-10-01$62.21Not available in this settingRVU21D
2021-07-01$62.21Not available in this settingRVU21C
2021-04-01$62.21Not available in this settingRVU21B
2021-01-01$62.21Not available in this settingRVU21A
2020-10-01$58.72Not available in this settingRVU20D
2020-07-01$58.72Not available in this settingRVU20C
2020-04-01$58.72Not available in this settingRVU20B
2020-01-01$58.72Not available in this settingRVU20A
2019-10-01$59.51Not available in this settingRVU19D
2019-07-01$59.51Not available in this settingRVU19C
2019-04-01$59.51Not available in this settingRVU19B
2019-01-01$59.51Not available in this settingRVU19A
2018-10-01$59.45Not available in this settingRVU18D
2018-07-01$59.45Not available in this settingRVU18C
2018-04-01$59.45Not available in this settingRVU18B
2018-01-01$59.45Not available in this settingRVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 95249 for an earlier date of service

Where the Miami, FL rate applies

Miami, FL is a Medicare payment area, not a city. Our Census mapping connects it to 83 cities and communities in Florida. Some span more than one payment area; confirm with the service ZIP.

  • Miami
  • Aventura
  • Bal Harbour
  • Bay Harbor Islands
  • Big Coppitt Key
  • Big Pine Key
  • Biscayne Gardens
  • Biscayne Park

Browse all communities in Florida

95249 billing questions

How is 95249 different from 95250?

95249 is for setup and training using the patient’s own CGM equipment. Use 95250 when the equipment is provided by the physician or qualified health professional.

Does 95249 include interpretation of the CGM data?

No. CMS identifies 95249 as technical-component-only; the separate interpretation and report are covered by 95251 when performed.

What documentation supports reporting 95249?

Document that the patient supplied the equipment, the sensor and monitor setup and training performed, the monitoring period of at least 72 hours, and the resulting printout.

Can 95249 and 95251 be reported together?

They may be reported for the same patient when the setup service and a separate analysis, interpretation, and report are performed and documented.

Is 95249 reported for fewer than 72 hours of monitoring?

The service is defined for monitoring of at least 72 hours. The record should support that duration.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 95249PPRRVU2026_Oct_nonQPP.csv, line 12,491 (RVU26D)
Geographic factors for Miami, FLGPCI2026.csv, line 42 (RVU26D)

Open CMS sourceHow we calculate rates

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