$166.36–$218.60
Choose 95249 when the patient provides the CGM equipment; choose 95250 when the physician or qualified health professional provides it.
On this page
CMS RVU26D · Effective 2026-10-01
95249 CGM setup Medicare reimbursement rates in California
Reports setup and patient training for a personal continuous glucose monitor, including sensor placement and device preparation for at least 72 hours of monitoring. Compare 95249 office and facility rates across CMS payment localities in California.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 95249 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
$75.76–$99.45
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $23.69 per service.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 95249 pays more and less in California
29 payment localities
$75.76 to $99.45
Diabetes services
About 95249: Personal continuous glucose monitor setup and training
Reports setup and patient training for a personal continuous glucose monitor, including sensor placement and device preparation for at least 72 hours of monitoring.
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.
CMS billing rules for 95249
- Professional and technical components
- Technical-component-only code: a separate code covers interpretation.
Where the value comes from
- Work RVU0.00 · 0%
- Practice expense (office) RVU2.05 · 98%
- Malpractice RVU0.04 · 2%
19.8K
Medicare services in 2024 · #1153 by national volume
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.
95249 compared with similar codes
Office rates for California, from the same CMS release.
$35.71–$41.52
95249 covers device setup and patient training. 95251 covers analysis, interpretation, and a report based on CGM data.
82947
No office rateAssay 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.
Compare 95249 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office $75.86 | Facility Unavailable |
| Chico | Office $75.76 | Facility Unavailable |
| El Centro | Office $75.77 | Facility Unavailable |
| Fresno | Office $75.76 | Facility Unavailable |
| Hanford-Corcoran | Office $75.76 | Facility Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $81.89 | Facility Unavailable |
| Madera | Office $75.76 | Facility Unavailable |
| Merced | Office $75.76 | Facility Unavailable |
| Modesto | Office $75.76 | Facility Unavailable |
| Napa | Office $90.92 | Facility Unavailable |
| Oxnard-Thousand Oaks-Ventura | Office $81.77 | Facility Unavailable |
| Redding | Office $75.76 | Facility Unavailable |
| Rest Of California | Office $75.76 | Facility Unavailable |
| Riverside-San Bernardino-Ontario | Office $76.18 | Facility Unavailable |
| Sacramento-Roseville-Folsom | Office $80.35 | Facility Unavailable |
| Salinas | Office $80.07 | Facility Unavailable |
| San Diego-Chula Vista-Carlsbad | Office $82.62 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $97.16 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $97.11 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $99.45 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $99.27 | Facility Unavailable |
| San Luis Obispo-Paso Robles | Office $78.71 | Facility Unavailable |
| Santa Cruz-Watsonville | Office $83.91 | Facility Unavailable |
| Santa Maria-Santa Barbara | Office $80.55 | Facility Unavailable |
| Santa Rosa-Petaluma | Office $84.80 | Facility Unavailable |
| Stockton | Office $75.76 | Facility Unavailable |
| Vallejo | Office $90.86 | Facility Unavailable |
| Visalia | Office $75.76 | Facility Unavailable |
| Yuba City | Office $75.76 | Facility Unavailable |
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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
12,48895170,,Antigen therapy services,A,,0.06,0.25,,0.01,,0.01,0.32,0.08,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,48995180,,Rapid desensitization,A,,2.01,2.04,,0.52,,0.07,4.12,2.60,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,49095199,,Unlisted all/immlg svc/px,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,49195249,,Cont gluc mntr pt prov eqp,A,,0.00,2.05,,2.05,NA,0.04,2.09,2.09,3,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,49295250,,Cont gluc mntr phys/qhp eqp,A,,0.00,4.52,,4.52,NA,0.05,4.57,4.57,3,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,49395251,,Cont gluc mntr analysis i&r,A,,0.68,0.32,,0.32,,0.05,1.05,1.05,2,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,49495700,,Eeg cont rec w/vid eeg tech,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00