CPT code 95250: CGM setup, practice-supplied equipment2026 Medicare rate & RVUs in Vermont
Report this service when a practice places and manages its professional continuous glucose monitor for a patient whose glucose patterns need assessment.
In Vermont, Medicare pays $150.31 for 95250 in the office.
Check a contract rate as a % of Medicare · 95250 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 95250 covers
This service covers the technical work of a professional continuous glucose monitoring session using equipment supplied by the practice. A physician, qualified health care professional, or trained clinical staff member working under appropriate supervision may place the sensor, connect and prepare the monitor, instruct the patient on wearing it, and remove it after data collection. Endocrinology and diabetes practices commonly use it to capture glucose patterns that are not clear from routine readings, including overnight or between-meal trends.
Report the service for the practice’s sensor setup and related technical work, not for analysis of the recorded results. Documentation should support the clinical reason for monitoring and record the setup and sensor removal. CMS classifies 95250 as technical-component-only; a separate code, 95251, covers the interpretation and report when those services are performed. The separate interpretation should be supported by review of the recorded data and a documented report.
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 Vermont compares for 95250
Across 109 of 109 payment localities, the office rate for 95250 runs from $130.55 in Arkansas to $218.60 in San Benito County, CA. Vermont pays $150.31. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Vermont · this page$150.31
- Los Angeles, CA · California$179.71+$29.40
- Washington, DC area · District of Columbia$179.70+$29.39
- Miami, FL · Florida$161.39+$11.08
- Chicago, IL · Illinois$155.56+$5.25
- Manhattan, NY · New York$178.08+$27.77
- Alaska · Alaska$161.71+$11.40
Other areas in Vermont first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $133.05 | — |
| ArkansasArkansas | $130.55 | — |
| ArizonaArizona | $147.72 | — |
| Bakersfield, CACalifornia | $166.48 | — |
| Chico, CACalifornia | $166.36 | — |
| El Centro, CACalifornia | $166.37 | — |
| Fresno, CACalifornia | $166.36 | — |
| Hanford, CACalifornia | $166.36 | — |
| Madera, CACalifornia | $166.36 | — |
| Merced, CACalifornia | $166.36 | — |
| Modesto, CACalifornia | $166.36 | — |
| Napa, CACalifornia | $199.83 | — |
| Oxnard, CACalifornia | $179.49 | — |
| Redding, CACalifornia | $166.36 | — |
| Rest of CaliforniaCalifornia | $166.36 | — |
| Riverside, CACalifornia | $166.89 | — |
| Sacramento, CACalifornia | $176.48 | — |
| Salinas, CACalifornia | $175.87 | — |
| San Diego, CACalifornia | $181.47 | — |
| Marin County, CACalifornia | $213.64 | — |
| San Francisco, CACalifornia | $213.58 | — |
| San Benito County, CACalifornia | $218.60 | — |
| Santa Clara County, CACalifornia | $218.36 | — |
| San Luis Obispo, CACalifornia | $172.85 | — |
| Santa Cruz, CACalifornia | $184.33 | — |
| Santa Maria, CACalifornia | $176.93 | — |
| Santa Rosa, CACalifornia | $186.29 | — |
| Stockton, CACalifornia | $166.36 | — |
| Vallejo, CACalifornia | $199.75 | — |
| Visalia, CACalifornia | $166.36 | — |
| Yuba City, CACalifornia | $166.36 | — |
| ColoradoColorado | $161.94 | — |
| ConnecticutConnecticut | $164.62 | — |
| DelawareDelaware | $150.66 | — |
| Fort Lauderdale, FLFlorida | $155.95 | — |
| Rest of FloridaFlorida | $146.84 | — |
| Atlanta, GAGeorgia | $155.39 | — |
| Rest of GeorgiaGeorgia | $136.66 | — |
| Hawaii, Guam, HIHawaii | $172.62 | — |
| IowaIowa | $138.80 | — |
| IdahoIdaho | $139.68 | — |
| East St. Louis, ILIllinois | $142.26 | — |
| Rest of IllinoisIllinois | $140.45 | — |
| Suburban Chicago, ILIllinois | $158.01 | — |
| IndianaIndiana | $140.76 | — |
| KansasKansas | $137.32 | — |
| KentuckyKentucky | $135.74 | — |
| New Orleans, LALouisiana | $143.96 | — |
| Rest of LouisianaLouisiana | $135.21 | — |
| Metropolitan Boston, MAMassachusetts | $181.75 | — |
| Rest of MassachusettsMassachusetts | $160.30 | — |
| Baltimore area, MDMaryland | $164.06 | — |
| Rest of MarylandMaryland | $154.32 | — |
| Rest of MaineMaine | $139.93 | — |
| Southern Maine, MEMaine | $150.67 | — |
| Detroit, MIMichigan | $148.50 | — |
| Rest of MichiganMichigan | $139.72 | — |
| MinnesotaMinnesota | $155.84 | — |
| Metropolitan Kansas City, MOMissouri | $143.39 | — |
| Metropolitan St. Louis, MOMissouri | $145.40 | — |
| Rest of MissouriMissouri | $131.76 | — |
| MississippiMississippi | $131.22 | — |
| MontanaMontana | $152.64 | — |
| North CarolinaNorth Carolina | $141.92 | — |
| North DakotaNorth Dakota | $151.65 | — |
| NebraskaNebraska | $139.98 | — |
| New HampshireNew Hampshire | $158.62 | — |
| Northern New JerseyNew Jersey | $176.91 | — |
| Rest of New JerseyNew Jersey | $166.69 | — |
| New MexicoNew Mexico | $140.45 | — |
| NevadaNevada | $152.51 | — |
| NYC suburbs and Long Island, NYNew York | $182.61 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $167.34 | — |
| Queens, NYNew York | $180.86 | — |
| Rest of New YorkNew York | $144.60 | — |
| OhioOhio | $139.52 | — |
| OklahomaOklahoma | $136.12 | — |
| Portland, OROregon | $168.97 | — |
| Rest of OregonOregon | $151.54 | — |
| Metropolitan Philadelphia, PAPennsylvania | $159.15 | — |
| Rest of PennsylvaniaPennsylvania | $140.17 | — |
| Puerto RicoPuerto Rico | $154.28 | — |
| Rhode IslandRhode Island | $157.44 | — |
| South CarolinaSouth Carolina | $140.92 | — |
| South DakotaSouth Dakota | $151.53 | — |
| TennesseeTennessee | $138.13 | — |
| Austin, TXTexas | $161.21 | — |
| Beaumont, TXTexas | $138.94 | — |
| Brazoria, TXTexas | $150.92 | — |
| Dallas, TXTexas | $151.80 | — |
| Fort Worth, TXTexas | $150.31 | — |
| Galveston, TXTexas | $151.30 | — |
| Houston, TXTexas | $152.21 | — |
| Rest of TexasTexas | $144.78 | — |
| UtahUtah | $143.41 | — |
| VirginiaVirginia | $149.58 | — |
| Virgin Islands, VIUnited States Virgin Islands | $154.28 | — |
| Rest of WashingtonWashington | $160.24 | — |
| King County, WAWashington | $186.61 | — |
| WisconsinWisconsin | $145.15 | — |
| West VirginiaWest Virginia | $133.58 | — |
| WyomingWyoming | $152.21 | — |
95250 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$130.55
$192.48
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $161.71 | 1 |
| AL | $133.05 | 1 |
| AR | $130.55 | 1 |
| AZ | $147.72 | 1 |
| CA | $166.36–$218.60 | 29 |
| CO | $161.94 | 1 |
| CT | $164.62 | 1 |
| DC | $179.70 | 1 |
| DE | $150.66 | 1 |
| FL | $146.84–$161.39 | 3 |
| GA | $136.66–$155.39 | 2 |
| GU | $172.62 | 1 |
| HI | $172.62 | 1 |
| IA | $138.80 | 1 |
| ID | $139.68 | 1 |
| IL | $140.45–$158.01 | 4 |
| IN | $140.76 | 1 |
| KS | $137.32 | 1 |
| KY | $135.74 | 1 |
| LA | $135.21–$143.96 | 2 |
| MA | $160.30–$181.75 | 2 |
| MD | $154.32–$179.70 | 3 |
| ME | $139.93–$150.67 | 2 |
| MI | $139.72–$148.50 | 2 |
| MN | $155.84 | 1 |
| MO | $131.76–$145.40 | 3 |
| MS | $131.22 | 1 |
| MT | $152.64 | 1 |
| NC | $141.92 | 1 |
| ND | $151.65 | 1 |
| NE | $139.98 | 1 |
| NH | $158.62 | 1 |
| NJ | $166.69–$176.91 | 2 |
| NM | $140.45 | 1 |
| NV | $152.51 | 1 |
| NY | $144.60–$182.61 | 5 |
| OH | $139.52 | 1 |
| OK | $136.12 | 1 |
| OR | $151.54–$168.97 | 2 |
| PA | $140.17–$159.15 | 2 |
| PR | $154.28 | 1 |
| RI | $157.44 | 1 |
| SC | $140.92 | 1 |
| SD | $151.53 | 1 |
| TN | $138.13 | 1 |
| TX | $138.94–$161.21 | 8 |
| UT | $143.41 | 1 |
| VA | $149.58–$179.70 | 2 |
| VI | $154.28 | 1 |
| VT | $150.31 | 1 |
| WA | $160.24–$186.61 | 2 |
| WI | $145.15 | 1 |
| WV | $133.58 | 1 |
| WY | $152.21 | 1 |
How the 95250 rate is calculated
Each of 95250’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 · 95250
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense4.52
4.52 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
4.5700
Conversion factor
$33.4009
Medicare rate
$152.64
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Vermont inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,492
- Code
- 95250
- Physician work
- 0.00
- Practice expense
- 4.52
- Malpractice
- 0.05
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 4.52 | × 0.990 | 4.4748 |
| Malpractice | 0.05 | × 0.506 | 0.0253 |
| Total RVUs | 4.5001 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Vermont$150.31
Office: (0 × 1 + 4.52 × 0.99 + 0.05 × 0.506) × $33.4009 = $150.31
Payment rules and modifiers for 95250
The CMS indicators that decide how 95250 is paid alongside other services.
CMS payment indicators · 95250
CGM setup, practice-supplied equipment
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 3 | Technical component only. |
How 95250 has changed in Vermont
95250 · Office / nonfacility
$150.31
Effective 2026-10-01
The base rate is $12.49 higher than on 2025-10-01, moving from $137.82 to $150.31 (9.1%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$137.82changed to$150.31
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 4.27 changed to 4.52
- Malpractice RVU 0.04 changed to 0.05
- Practice expense GPCI 0.993 changed to 0.990
- Malpractice GPCI 0.518 changed to 0.506
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$145.80changed to$137.82
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 4.39 changed to 4.27
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$143.42changed to$145.80
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$146.01changed to$143.42
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 4.30 changed to 4.39
- Practice expense GPCI 0.997 changed to 0.993
- Malpractice GPCI 0.543 changed to 0.518
January 1, 2023
RVU23A
$151.13changed to$146.01
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 4.34 changed to 4.30
- Practice expense GPCI 1.001 changed to 0.997
- Malpractice GPCI 0.569 changed to 0.543
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$156.92changed to$151.13
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 4.47 changed to 4.34
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$153.11changed to$156.92
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 4.18 changed to 4.47
- Malpractice RVU 0.05 changed to 0.04
- Practice expense GPCI 1.008 changed to 1.001
- Malpractice GPCI 0.582 changed to 0.569
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$155.22changed to$153.11
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 4.22 changed to 4.18
- Malpractice RVU 0.04 changed to 0.05
- Practice expense GPCI 1.015 changed to 1.008
- Malpractice GPCI 0.595 changed to 0.582
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$158.34changed to$155.22
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 4.31 changed to 4.22
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$160.77changed to$158.34
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 4.41 changed to 4.31
- Practice expense GPCI 1.010 changed to 1.015
- Malpractice GPCI 0.639 changed to 0.595
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$159.86changed to$160.77
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 4.42 changed to 4.41
- Practice expense GPCI 1.004 changed to 1.010
- Malpractice GPCI 0.682 changed to 0.639
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$159.95changed to$159.86
- Conversion factor 35.9335 changed to 35.8043
- Malpractice RVU 0.02 changed to 0.04
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$159.16changed to$159.95
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$158.07changed to$159.16
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 4.38 changed to 4.42
- Malpractice RVU 0.01 changed to 0.02
- Practice expense GPCI 1.006 changed to 1.004
- Malpractice GPCI 0.618 changed to 0.682
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$158.07
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $150.31 | Not available in this setting | RVU26D |
| 2026-07-01 | $150.31 | Not available in this setting | RVU26C |
| 2026-04-01 | $150.31 | Not available in this setting | RVU26B |
| 2026-01-01 | $150.31 | Not available in this setting | RVU26A |
| 2025-10-01 | $137.82 | Not available in this setting | RVU25D |
| 2025-07-01 | $137.82 | Not available in this setting | RVU25C |
| 2025-04-01 | $137.82 | Not available in this setting | RVU25B |
| 2025-01-01 | $137.82 | Not available in this setting | RVU25A |
| 2024-10-01 | $145.80 | Not available in this setting | RVU24D |
| 2024-07-01 | $145.80 | Not available in this setting | RVU24C |
| 2024-04-01 | $145.80 | Not available in this setting | RVU24B |
| 2024-03-09 | $145.80 | Not available in this setting | RVU24AR |
| 2024-01-01 | $143.42 | Not available in this setting | RVU24A |
| 2023-10-01 | $146.01 | Not available in this setting | RVU23D |
| 2023-07-01 | $146.01 | Not available in this setting | RVU23C |
| 2023-04-01 | $146.01 | Not available in this setting | RVU23B |
| 2023-01-01 | $146.01 | Not available in this setting | RVU23A |
| 2022-10-01 | $151.13 | Not available in this setting | RVU22D |
| 2022-07-01 | $151.13 | Not available in this setting | RVU22C |
| 2022-04-01 | $151.13 | Not available in this setting | RVU22B |
| 2022-01-01 | $151.13 | Not available in this setting | RVU22A |
| 2021-10-01 | $156.92 | Not available in this setting | RVU21D |
| 2021-07-01 | $156.92 | Not available in this setting | RVU21C |
| 2021-04-01 | $156.92 | Not available in this setting | RVU21B |
| 2021-01-01 | $156.92 | Not available in this setting | RVU21A |
| 2020-10-01 | $153.11 | Not available in this setting | RVU20D |
| 2020-07-01 | $153.11 | Not available in this setting | RVU20C |
| 2020-04-01 | $153.11 | Not available in this setting | RVU20B |
| 2020-01-01 | $153.11 | Not available in this setting | RVU20A |
| 2019-10-01 | $155.22 | Not available in this setting | RVU19D |
| 2019-07-01 | $155.22 | Not available in this setting | RVU19C |
| 2019-04-01 | $155.22 | Not available in this setting | RVU19B |
| 2019-01-01 | $155.22 | Not available in this setting | RVU19A |
| 2018-10-01 | $158.34 | Not available in this setting | RVU18D |
| 2018-07-01 | $158.34 | Not available in this setting | RVU18C |
| 2018-04-01 | $158.34 | Not available in this setting | RVU18B |
| 2018-01-01 | $158.34 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $160.77 | Not available in this setting | RVU17D |
| 2017-07-01 | $160.77 | Not available in this setting | RVU17C |
| 2017-04-01 | $160.77 | Not available in this setting | RVU17B |
| 2017-01-01 | $160.77 | Not available in this setting | RVU17A |
| 2016-10-01 | $159.86 | Not available in this setting | RVU16D |
| 2016-07-01 | $159.86 | Not available in this setting | RVU16C |
| 2016-04-01 | $159.86 | Not available in this setting | RVU16B |
| 2016-01-01 | $159.86 | Not available in this setting | RVU16A |
| 2015-10-01 | $159.95 | Not available in this setting | RVU15D |
| 2015-07-01 | $159.95 | Not available in this setting | RVU15C |
| 2015-04-01 | $159.16 | Not available in this setting | RVU15B |
| 2015-01-01 | $159.16 | Not available in this setting | RVU15A |
| 2014-10-01 | $158.07 | Not available in this setting | RVU14D |
| 2014-07-01 | $158.07 | Not available in this setting | RVU14C |
| 2014-04-01 | $158.07 | Not available in this setting | RVU14B |
| 2014-01-01 | $158.07 | Not available in this setting | RVU14A |
| 2013-10-01 | Rate data unavailable | Not available in this setting | RVU13D |
| 2013-07-01 | Rate data unavailable | Not available in this setting | RVU13C |
| 2013-04-01 | Rate data unavailable | Not available in this setting | RVU13B |
| 2013-01-01 | Rate data unavailable | Not available in this setting | RVU13AR |
Where the Vermont rate applies
Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.
- Albany
- Alburgh
- Algiers
- Arlington
- Ascutney
- Bakersfield
- Barnet
- Barre
95250 billing questions
How does 95250 differ from 95249?
95250 is for professional monitoring equipment supplied by the practice. 95249 is used when the patient’s own continuous glucose monitoring equipment is set up.
Does 95250 include interpretation of the glucose data?
No. It covers the technical work; report 95251 separately when the data are analyzed and an interpretation and report are completed.
Can 95250 and 95251 be reported for the same monitoring session?
Yes, when both the technical service and the separate analysis, interpretation, and report are performed and documented.
What documentation supports 95250?
Document the clinical reason for professional monitoring, sensor setup, patient instructions, and removal. Keep interpretation findings in the record when 95251 is also reported.
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
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