How to Set up Professional Continuous Glucose Monitoring

Continuous glucose monitoring (CGM) is one of many remote monitoring programs that can easily be managed in family medicine offices. CGM can provide more data about your patient's glucose trends than periodic finger sticks. Watch a practice hack and review highlights from the video to learn easy steps for setting up professional CGM in your practice.

Get Administrative Buy-in

If you need to speak with your administration before implementing CGM, be prepared to talk about the challenges of treating diabetes and explain the benefits of CGM.

Be prepared to also make a financial business case that:

• Estimates staffing needs

• Estimates projected use of CGM

• Maps out the billing and coding process [link to new rpm/cgm billing page]

• Creates a full picture of benefits and revenue potential

Select a CGM Device

Four devices are available for CGM.

When choosing a device, compare each system carefully to make sure you understand their features, cost, and related software. Factors to compare devices on include:

• Data transmission frequency (continuous or intermittent)

• Data type (blind or unblinded) 

• Sensor duration  

• Warmup time

• Accuracy (mean absolute relative difference)

• Calibration options

• Cost and Purchase Options

• Software requirements

Identify a Staff Expert and Develop a Patient List

Pick one or more people on your staff to become an expert on CGM processes, so that you have a go-to person when questions or issues arise. Medical assistants, licensed vocational nurses, diabetes educators, or dietitians can be good candidates for this role.

Make sure you choose staff who have good communication and patient education skills, so that they can successful help patients use the device.

Your staff expert can help you find patients who are interested in and could most benefit from CGM. This list might include patients who have:

• Uncontrolled diabetes

• Lack of hypoglycemia awareness

• Discordant A1C and fingerstick readings

• Diabetes mellitus with hypoglycemia or labial blood glucose

Develop a Workflow

There are three basic steps in a standardized CGM workflow:

1. Understand insurance eligibility and prior authorization processes for CGM. CGM is payable by Medicare, but the criteria can vary by Medicare Administrative Contractor. Get help successfully ordering CGM with steps from the AAFP.

2. Insert the CGM sensor after you’ve received prior authorizations and provide the patient with instructions. This can be done the same day as an office visit.

3. After the patient returns the expired sensor, extract the data and upload it to the device’s software program.

Staff can share the reports with the ordering physician who will determine next steps.

Want to learn how an efficient telemedicine workflow can contribute to achieving administrative simplificaiton? The AAFP's technology CME package includes education to help you reduce burden, including through the use of telehealth.