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Continuous Glucose Monitoring (CGM) claims dated on or after December 2023 are reimbursed as per Circular 33/23 which was effective from 1 December 2023.
Under community drug schemes, pharmacies can only claim reimbursement once every two-months for a supply of 10 Medtronic Guardian sensors. Consequently, PCRS will reject claims that are submitted each month.
Claims for quantities exceeding those specified in Circular 33/23 will not be supported unless the pharmacy has obtained prior approval from the Pharmacy Function team in the PCRS.
If a replacement sensor is needed outside the regular usage period, patients should be advised to contact the respective company to arrange for a replacement under their sensor replacement policies. See contact details here.
