CPT code 95251: CGM interpretation, analysis, interpretation, and report2026 Medicare rate & RVUs in South Dakota

In South Dakota, Medicare pays $33.96 for 95251 in the office and $33.96 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 95251 nationwide

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

What 95251 covers

This service is the clinician's evaluation of at least 72 hours of interstitial glucose readings recorded by a subcutaneous sensor. A physician, nurse practitioner, or physician assistant reviews a downloaded or remotely uploaded ambulatory glucose profile from a Dexcom, FreeStyle Libre, or similar system. The practitioner assesses time in range, low and high glucose excursions, overnight and postprandial patterns, and variability, then writes patient-specific findings and recommendations such as insulin dose or timing changes. Endocrinology and primary care practices perform these reviews for patients with type 1 or insulin-treated type 2 diabetes.

Report 95251 no more than once per month for a monitoring period of at least 72 hours, even if data are reviewed multiple times. Document the monitoring dates and a signed interpretation; a device printout without clinical analysis is insufficient. CMS classifies 95251 as professional-component-only, covering analysis, interpretation, and report; do not append modifier 26. When performed, patient-owned CGM startup and training are described by 95249, while 95250 describes setup and recording using practice-provided equipment. Neither technical service is required for 95251 when a patient's existing device provides the data.

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 South Dakota compares for 95251

Across 109 of 109 payment localities, the office rate for 95251 runs from $32.75 in Arkansas to $46.37 in Alaska. South Dakota pays $33.96. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

95251 rates by state

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

See 95251 in every payment locality

How the 95251 rate is calculated

Each of 95251’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.

Payment rules and modifiers for 95251

The CMS indicators that decide how 95251 is paid alongside other services.

Codes related to 95251

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

How 95251 has changed in South Dakota

Price 95251 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

• Aberdeen
• Agar
• Agency Village
• Akaska
• Albee
• Alcester
• Alexandria
• Allen

Browse all communities in South Dakota

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

Open CMS sourceHow we calculate rates