Billing code 95249: CGM setupMedicare rate & RVUs
Reports setup and patient training for a personal continuous glucose monitor, including sensor placement and device preparation for at least 72 hours of monitoring.
Medicare pays $69.81 for 95249 nationally in the office. Local office rates run $59.51–$99.45.
Medicare rate · 95249
CGM setup
Swap in your local Medicare rate.
- Work RVUs
- 0
- Total RVUs
- 2.09
- Global days
- XXX
National rate · 2026
$69.81
Office setting, before claim adjustments.
See every locality for 95249 → · Billed by an NP, PA or therapist? →
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 10 sections
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.
Where 95249 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$59.51 to $99.45
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $60.67 | Unavailable |
| Alaska* | $73.66 | Unavailable |
| Arizona | $67.49 | Unavailable |
| Arkansas | $59.51 | Unavailable |
| Atlanta | $71.17 | Unavailable |
| Austin | $73.63 | Unavailable |
| Bakersfield | $75.86 | Unavailable |
| Baltimore/Surr. Cntys | $75.12 | Unavailable |
| Beaumont | $63.55 | Unavailable |
| Brazoria | $68.90 | Unavailable |
| Chicago | $71.88 | Unavailable |
| Chico | $75.76 | Unavailable |
| Colorado | $73.90 | Unavailable |
| Connecticut | $75.36 | Unavailable |
| Dallas | $69.34 | Unavailable |
| Dc + Md/Va Suburbs | $82.15 | Unavailable |
| Delaware | $68.85 | Unavailable |
| Detroit | $68.33 | Unavailable |
| East St. Louis | $65.68 | Unavailable |
| El Centro | $75.77 | Unavailable |
| Fort Lauderdale | $71.78 | Unavailable |
| Fort Worth | $68.68 | Unavailable |
| Fresno | $75.76 | Unavailable |
| Galveston | $69.10 | Unavailable |
| Hanford-Corcoran | $75.76 | Unavailable |
| Hawaii, Guam | $78.63 | Unavailable |
| Houston | $69.83 | Unavailable |
| Idaho | $63.63 | Unavailable |
| Indiana | $64.12 | Unavailable |
| Iowa | $63.18 | Unavailable |
| Kansas | $62.57 | Unavailable |
| Kentucky | $62.09 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $81.89 | Unavailable |
| Madera | $75.76 | Unavailable |
| Manhattan | $81.68 | Unavailable |
| Merced | $75.76 | Unavailable |
| Metropolitan Boston | $82.94 | Unavailable |
| Metropolitan Kansas City | $65.60 | Unavailable |
| Metropolitan Philadelphia | $72.87 | Unavailable |
| Metropolitan St. Louis | $66.52 | Unavailable |
| Miami | $74.66 | Unavailable |
| Minnesota | $70.85 | Unavailable |
| Mississippi | $59.94 | Unavailable |
| Modesto | $75.76 | Unavailable |
| Montana** | $69.81 | Unavailable |
| Napa | $90.92 | Unavailable |
| Nebraska | $63.70 | Unavailable |
| Nevada** | $69.65 | Unavailable |
| New Hampshire | $72.45 | Unavailable |
| New Mexico | $64.39 | Unavailable |
| New Orleans | $65.95 | Unavailable |
| North Carolina | $64.74 | Unavailable |
| North Dakota** | $69.01 | Unavailable |
| Northern Nj | $80.85 | Unavailable |
| Nyc Suburbs/Long Island | $83.89 | Unavailable |
| Ohio | $63.86 | Unavailable |
| Oklahoma | $62.18 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $81.77 | Unavailable |
| Portland | $77.07 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $76.59 | Unavailable |
| Puerto Rico | $70.54 | Unavailable |
| Queens | $82.86 | Unavailable |
| Redding | $75.76 | Unavailable |
| Rest Of California | $75.76 | Unavailable |
| Rest Of Florida | $67.47 | Unavailable |
| Rest Of Georgia | $62.67 | Unavailable |
| Rest Of Illinois | $64.60 | Unavailable |
| Rest Of Louisiana | $61.88 | Unavailable |
| Rest Of Maine | $63.83 | Unavailable |
| Rest Of Maryland | $70.52 | Unavailable |
| Rest Of Massachusetts | $73.17 | Unavailable |
| Rest Of Michigan | $64.02 | Unavailable |
| Rest Of Missouri | $60.32 | Unavailable |
| Rest Of New Jersey | $76.24 | Unavailable |
| Rest Of New York | $65.99 | Unavailable |
| Rest Of Oregon | $69.14 | Unavailable |
| Rest Of Pennsylvania | $64.12 | Unavailable |
| Rest Of Texas | $66.19 | Unavailable |
| Rest Of Washington | $73.12 | Unavailable |
| Rhode Island | $71.92 | Unavailable |
| Riverside-San Bernardino-Ontario | $76.18 | Unavailable |
| Sacramento-Roseville-Folsom | $80.35 | Unavailable |
| Salinas | $80.07 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $82.62 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $97.16 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $97.11 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $99.45 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $99.27 | Unavailable |
| San Luis Obispo-Paso Robles | $78.71 | Unavailable |
| Santa Cruz-Watsonville | $83.91 | Unavailable |
| Santa Maria-Santa Barbara | $80.55 | Unavailable |
| Santa Rosa-Petaluma | $84.80 | Unavailable |
| Seattle (King Cnty) | $85.11 | Unavailable |
| South Carolina | $64.40 | Unavailable |
| South Dakota** | $68.92 | Unavailable |
| Southern Maine | $68.70 | Unavailable |
| Stockton | $75.76 | Unavailable |
| Suburban Chicago | $72.69 | Unavailable |
| Tennessee | $62.96 | Unavailable |
| Utah | $65.56 | Unavailable |
| Vallejo | $90.86 | Unavailable |
| Vermont | $68.46 | Unavailable |
| Virgin Islands | $70.54 | Unavailable |
| Virginia | $68.25 | Unavailable |
| Visalia | $75.76 | Unavailable |
| West Virginia | $61.41 | Unavailable |
| Wisconsin | $66.01 | Unavailable |
| Wyoming** | $69.46 | Unavailable |
| Yuba City | $75.76 | Unavailable |
95249 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.
$59.51
$87.61
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 | $73.66 | 1 |
| AL | $60.67 | 1 |
| AR | $59.51 | 1 |
| AZ | $67.49 | 1 |
| CA | $75.76–$99.45 | 29 |
| CO | $73.90 | 1 |
| CT | $75.36 | 1 |
| DC | $82.15 | 1 |
| DE | $68.85 | 1 |
| FL | $67.47–$74.66 | 3 |
| GA | $62.67–$71.17 | 2 |
| GU | $78.63 | 1 |
| HI | $78.63 | 1 |
| IA | $63.18 | 1 |
| ID | $63.63 | 1 |
| IL | $64.60–$72.69 | 4 |
| IN | $64.12 | 1 |
| KS | $62.57 | 1 |
| KY | $62.09 | 1 |
| LA | $61.88–$65.95 | 2 |
| MA | $73.17–$82.94 | 2 |
| MD | $70.52–$82.15 | 3 |
| ME | $63.83–$68.70 | 2 |
| MI | $64.02–$68.33 | 2 |
| MN | $70.85 | 1 |
| MO | $60.32–$66.52 | 3 |
| MS | $59.94 | 1 |
| MT | $69.81 | 1 |
| NC | $64.74 | 1 |
| ND | $69.01 | 1 |
| NE | $63.70 | 1 |
| NH | $72.45 | 1 |
| NJ | $76.24–$80.85 | 2 |
| NM | $64.39 | 1 |
| NV | $69.65 | 1 |
| NY | $65.99–$83.89 | 5 |
| OH | $63.86 | 1 |
| OK | $62.18 | 1 |
| OR | $69.14–$77.07 | 2 |
| PA | $64.12–$72.87 | 2 |
| PR | $70.54 | 1 |
| RI | $71.92 | 1 |
| SC | $64.40 | 1 |
| SD | $68.92 | 1 |
| TN | $62.96 | 1 |
| TX | $63.55–$73.63 | 8 |
| UT | $65.56 | 1 |
| VA | $68.25–$82.15 | 2 |
| VI | $70.54 | 1 |
| VT | $68.46 | 1 |
| WA | $73.12–$85.11 | 2 |
| WI | $66.01 | 1 |
| WV | $61.41 | 1 |
| WY | $69.46 | 1 |
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
Swap in your local Medicare rate.
Work 0.00Practice expense 2.05Malpractice 0.04
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 95249
The CMS indicators that decide how 95249 is paid alongside other services.
CMS payment indicators · 95249
CGM setup
| 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. |
95249 compared with similar codes
Compare codes
95249 vs 95250 vs 95251 vs 82947: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 95250CGM setup
- Choose 95249 when the patient provides the CGM equipment; choose 95250 when the physician or qualified health professional provides it.
- 95251CGM interpretation
- 95249 covers device setup and patient training. 95251 covers analysis, interpretation, and a report based on CGM data.
- 82947Assay glucose blood quant
- 82947 represents a quantitative blood glucose test, not CGM sensor setup or patient training; report it only when that test is separately performed.
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
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