$62.09
Choose 95249 when the patient provides the monitoring equipment; 95250 describes technical setup using practice-supplied professional equipment.
On this page
CMS RVU26D · Effective 2026-10-01
95250 CGM setup Medicare reimbursement rates in Kentucky
Report this service when a practice places and manages its professional continuous glucose monitor for a patient whose glucose patterns need assessment. Compare 95250 office and facility rates across CMS payment localities in Kentucky.
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 95250 in Kentucky?
Kentucky has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$135.74
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
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.
Diabetes monitoring
About 95250: Professional continuous glucose monitor setup
Report this service when a practice places and manages its professional continuous glucose monitor for a patient whose glucose patterns need assessment.
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.
CMS billing rules for 95250
- 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) RVU4.52 · 99%
- Malpractice RVU0.05 · 1%
32.9K
Medicare services in 2024 · #938 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.
95250 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$33.74
95251 represents analysis, interpretation, and reporting of the recorded data. It is separate from the equipment setup and sensor-management work in 95250.
Compare 95250 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.
1 of 1 payment localities
Kentucky →
Office / nonfacility
$135.74
Facility
Unavailable
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 95250 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
12,492
- Code
- 95250
- Physician work
- 0.00
- Practice expense
- 4.52
- Malpractice
- 0.05
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 4.52 | × 0.889 | 4.0183 |
| Malpractice | 0.05 | × 0.915 | 0.0458 |
| Total RVUs | 4.0640 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$135.74
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1 |
| Practice expense | 4.52 | 0.889 |
| Malpractice | 0.05 | 0.915 |
(0 × 1 + 4.52 × 0.889 + 0.05 × 0.915) × $33.4009 = $135.74
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 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.
12,48995180,,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
12,49595705,,Eeg w/o vid 2-12 hr unmntr,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
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631