Billing code 95250: CGM setupMedicare rate & RVUs
Report this service when a practice places and manages its professional continuous glucose monitor for a patient whose glucose patterns need assessment.
Medicare pays $152.64 for 95250 nationally in the office. Local office rates run $130.55–$218.60.
Medicare rate · 95250
CGM setup
Swap in your local Medicare rate.
- Work RVUs
- 0
- Total RVUs
- 4.57
- Global days
- XXX
National rate · 2026
$152.64
Office setting, before claim adjustments.
See every locality for 95250 → · 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 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.
Where 95250 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
$130.55 to $218.60
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $133.05 | Unavailable |
| Alaska* | $161.71 | Unavailable |
| Arizona | $147.72 | Unavailable |
| Arkansas | $130.55 | Unavailable |
| Atlanta | $155.39 | Unavailable |
| Austin | $161.21 | Unavailable |
| Bakersfield | $166.48 | Unavailable |
| Baltimore/Surr. Cntys | $164.06 | Unavailable |
| Beaumont | $138.94 | Unavailable |
| Brazoria | $150.92 | Unavailable |
| Chicago | $155.56 | Unavailable |
| Chico | $166.36 | Unavailable |
| Colorado | $161.94 | Unavailable |
| Connecticut | $164.62 | Unavailable |
| Dallas | $151.80 | Unavailable |
| Dc + Md/Va Suburbs | $179.70 | Unavailable |
| Delaware | $150.66 | Unavailable |
| Detroit | $148.50 | Unavailable |
| East St. Louis | $142.26 | Unavailable |
| El Centro | $166.37 | Unavailable |
| Fort Lauderdale | $155.95 | Unavailable |
| Fort Worth | $150.31 | Unavailable |
| Fresno | $166.36 | Unavailable |
| Galveston | $151.30 | Unavailable |
| Hanford-Corcoran | $166.36 | Unavailable |
| Hawaii, Guam | $172.62 | Unavailable |
| Houston | $152.21 | Unavailable |
| Idaho | $139.68 | Unavailable |
| Indiana | $140.76 | Unavailable |
| Iowa | $138.80 | Unavailable |
| Kansas | $137.32 | Unavailable |
| Kentucky | $135.74 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $179.71 | Unavailable |
| Madera | $166.36 | Unavailable |
| Manhattan | $178.08 | Unavailable |
| Merced | $166.36 | Unavailable |
| Metropolitan Boston | $181.75 | Unavailable |
| Metropolitan Kansas City | $143.39 | Unavailable |
| Metropolitan Philadelphia | $159.15 | Unavailable |
| Metropolitan St. Louis | $145.40 | Unavailable |
| Miami | $161.39 | Unavailable |
| Minnesota | $155.84 | Unavailable |
| Mississippi | $131.22 | Unavailable |
| Modesto | $166.36 | Unavailable |
| Montana** | $152.64 | Unavailable |
| Napa | $199.83 | Unavailable |
| Nebraska | $139.98 | Unavailable |
| Nevada** | $152.51 | Unavailable |
| New Hampshire | $158.62 | Unavailable |
| New Mexico | $140.45 | Unavailable |
| New Orleans | $143.96 | Unavailable |
| North Carolina | $141.92 | Unavailable |
| North Dakota** | $151.65 | Unavailable |
| Northern Nj | $176.91 | Unavailable |
| Nyc Suburbs/Long Island | $182.61 | Unavailable |
| Ohio | $139.52 | Unavailable |
| Oklahoma | $136.12 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $179.49 | Unavailable |
| Portland | $168.97 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $167.34 | Unavailable |
| Puerto Rico | $154.28 | Unavailable |
| Queens | $180.86 | Unavailable |
| Redding | $166.36 | Unavailable |
| Rest Of California | $166.36 | Unavailable |
| Rest Of Florida | $146.84 | Unavailable |
| Rest Of Georgia | $136.66 | Unavailable |
| Rest Of Illinois | $140.45 | Unavailable |
| Rest Of Louisiana | $135.21 | Unavailable |
| Rest Of Maine | $139.93 | Unavailable |
| Rest Of Maryland | $154.32 | Unavailable |
| Rest Of Massachusetts | $160.30 | Unavailable |
| Rest Of Michigan | $139.72 | Unavailable |
| Rest Of Missouri | $131.76 | Unavailable |
| Rest Of New Jersey | $166.69 | Unavailable |
| Rest Of New York | $144.60 | Unavailable |
| Rest Of Oregon | $151.54 | Unavailable |
| Rest Of Pennsylvania | $140.17 | Unavailable |
| Rest Of Texas | $144.78 | Unavailable |
| Rest Of Washington | $160.24 | Unavailable |
| Rhode Island | $157.44 | Unavailable |
| Riverside-San Bernardino-Ontario | $166.89 | Unavailable |
| Sacramento-Roseville-Folsom | $176.48 | Unavailable |
| Salinas | $175.87 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $181.47 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $213.64 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $213.58 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $218.60 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $218.36 | Unavailable |
| San Luis Obispo-Paso Robles | $172.85 | Unavailable |
| Santa Cruz-Watsonville | $184.33 | Unavailable |
| Santa Maria-Santa Barbara | $176.93 | Unavailable |
| Santa Rosa-Petaluma | $186.29 | Unavailable |
| Seattle (King Cnty) | $186.61 | Unavailable |
| South Carolina | $140.92 | Unavailable |
| South Dakota** | $151.53 | Unavailable |
| Southern Maine | $150.67 | Unavailable |
| Stockton | $166.36 | Unavailable |
| Suburban Chicago | $158.01 | Unavailable |
| Tennessee | $138.13 | Unavailable |
| Utah | $143.41 | Unavailable |
| Vallejo | $199.75 | Unavailable |
| Vermont | $150.31 | Unavailable |
| Virgin Islands | $154.28 | Unavailable |
| Virginia | $149.58 | Unavailable |
| Visalia | $166.36 | Unavailable |
| West Virginia | $133.58 | Unavailable |
| Wisconsin | $145.15 | Unavailable |
| Wyoming** | $152.21 | Unavailable |
| Yuba City | $166.36 | Unavailable |
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
Swap in your local Medicare rate.
Work 0.00Practice expense 4.52Malpractice 0.05
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 95250
The CMS indicators that decide how 95250 is paid alongside other services.
CMS payment indicators · 95250
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. |
95250 compared with similar codes
Compare codes
95250 vs 95249 vs 95251: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 95249CGM setup
- Choose 95249 when the patient provides the monitoring equipment; 95250 describes technical setup using practice-supplied professional equipment.
- 95251CGM interpretation
- 95251 represents analysis, interpretation, and reporting of the recorded data. It is separate from the equipment setup and sensor-management work in 95250.
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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