Diabetes Equipment and Supplies - (0106) — MM 0106 | CIGNA Coverage Update

Cigna modified MM 0106 for continuous glucose monitoring (CGM) systems, effective February 24, 2026. Here's what billing teams need to know.

Cigna Healthcare updated its Diabetes Equipment and Supplies coverage policy, MM 0106, covering CGM devices and supplies. This change affects nine HCPCS codes—including A4238, A4239, A9276, A9277, A9278, E2102, E2103, G0564, and E1399—used by endocrinology practices, DME suppliers, and any provider billing CGM systems for diabetes patients. If your team bills these codes, audit your documentation and prior authorization workflows now, before the February 24, 2026 effective date.

Quick-Reference Table

Cigna Continuous Glucose Monitor Coverage Criteria and Medical Necessity Requirements 2026

The Cigna continuous glucose monitor coverage policy under MM 0106 draws a clear line between two CGM categories: adjunctive and nonadjunctive systems. That distinction drives everything—which codes you bill, what documentation you need, and whether your claims pass or deny.

Adjunctive CGMs require the patient to confirm glucose readings with a traditional fingerstick before making treatment decisions. Nonadjunctive CGMs don't—they're approved for dosing decisions on their own. Cigna treats these differently, and your billing needs to reflect that.

For adjunctive systems, Cigna considers E2102 and A4238 medically necessary when criteria in the applicable coverage policy are met. For nonadjunctive systems, E2103 and A4239 are covered under the same framework. The supply allowance codes—A4238 and A4239—cover all CGM supplies in a bundle, so don't unbundle sensors, transmitters, and receivers into separate line items unless you have a specific reason to.

Speaking of separate billing: A9276 (the disposable sensor), A9277 (the external transmitter), and A9278 (the external receiver/monitor) are each considered medically necessary when criteria are met. These codes apply to nondurable medical equipment—not implantable systems. That matters for your DME billing documentation.

For the implantable 365-day system, G0564 covers the creation of a subcutaneous pocket with sensor insertion. This is a procedure code, not a supply code—it requires different documentation than your DME codes, and prior authorization requirements may apply separately.

The real issue here is documentation. Cigna CGM coverage requires medical necessity to be established at the patient level. Generic diabetes diagnoses won't carry a claim. Your records need to show the patient's diabetes type, treatment regimen, and clinical need for continuous monitoring versus standard glucose testing.

If you're billing CGM supplies to Cigna and haven't reviewed your documentation templates against the updated MM 0106 criteria, do that before February 24, 2026. A claim denial on a CGM bundle is expensive—these aren't low-dollar line items.

Cigna CGM Exclusions and Non-Covered Indications

One code in this policy doesn't get the medical necessity designation: E1399.

E1399 is the catch-all HCPCS code for miscellaneous durable medical equipment. Cigna considers it experimental, investigational, and unproven in this context. That means if your team is billing E1399 for CGM-adjacent equipment that doesn't fit a specific code, Cigna will deny it.

This is a pattern you've seen before—payers use the E&I designation on miscellaneous codes to close billing workarounds. The message here is clear: if a CGM device or supply doesn't map to A9276, A9277, A9278, A4238, A4239, E2102, E2103, or G0564, Cigna isn't covering it under this policy.

Don't use E1399 as a fallback. If you have a CGM component that doesn't fit an existing code, talk to your billing consultant before you submit. Billing E1399 for CGM equipment against Cigna is a denial waiting to happen.

Coverage Indications at a Glance

Cigna CGM Billing Guidelines and Action Items 2026

These are direct steps for your billing and revenue cycle team. Tie each one to the February 24, 2026 effective date.

CPT, HCPCS, and ICD-10 Codes for CGM Systems Under MM 0106

Covered HCPCS Codes (When Medical Necessity Criteria Are Met)

Not Covered / Experimental HCPCS Codes

Key ICD-10-CM Diagnosis Codes

The MM 0106 policy data does not list specific ICD-10-CM codes. Work with your clinical documentation team to ensure the appropriate diabetes diagnosis codes (from the E10–E13 range) are present and support the medical necessity criteria in the coverage policy before submitting claims.