Medicare Insulin Pump Requirements

I get a lot of searches from people looking for the Medicare c-peptide requirements so I thought that I would add a post with what those requirements are here.  I have also seen

some “misinformation” being posted on messages boards.  The most reliable information is directly from the source itself so I am putting the link to the CMS manual that covers insulin pump requirements.

Please note that besides either meeting Criterion A or B, you must meet the c-peptide requirements.  I recently saw someone post that anyone already having a pump would be able to continue pumping because Criterion B includes those already pumping.  However, the key words under the General CSII Criteria are “In addition to meeting Criterion A or B above,” so the c-peptide requirement must be met regardless of whether you meet the other requirements or not.

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