`95249` Cont gluc mntr pt prov eqp

What 95249 is

CMS fee schedule short descriptor: Cont gluc mntr pt prov eqp.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 95249 (CY2026)

	Work RVU	Practice expense RVU	Malpractice RVU	Total	Medicare rate
Non-facility (office)	0.00	2.05	0.04	2.09	$69.81
Facility (hospital, ASC)	0.00	2.05	0.04	2.09	$69.81

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.

Adjust for a Medicare locality:

Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.

Medically Unlikely Edit (MUE)

Medicare caps 95249 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 95249? These codes are bundled into it

95249 is a Column 1 code in 14 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 code	Short description	Modifier indicator
`0446T`	Insj impltbl glucose sensor	0 - no modifier bypass	Check pair
`0733T`	Rem r-t mtn nrehab ther sply	0 - no modifier bypass	Check pair
`36591`	Draw blood off venous device	0 - no modifier bypass	Check pair
`36592`	Collect blood from picc	0 - no modifier bypass	Check pair
`96523`	Irrig drug delivery device	0 - no modifier bypass	Check pair
`98975`	Rtm 1st set-up&pt educaj eqp	0 - no modifier bypass	Check pair
`98976`	Rtm dev sply resp sys 16-30d	0 - no modifier bypass	Check pair
`98977`	Rtm dev sply mscskl 16-30 d	0 - no modifier bypass	Check pair
`99091`	Collj & interpj data ea 30 d	1 - modifier may bypass	Check pair
`99453`	Rem mntr physiol param setup	0 - no modifier bypass	Check pair
`99454`	Rem mntr physiol param 16-30	0 - no modifier bypass	Check pair
`99473`	Self-meas bp pt educaj/train	0 - no modifier bypass	Check pair
`99474`	Self-meas bp 2 readg bid 30d	1 - modifier may bypass	Check pair
`G0248`	Demonstrate use home inr mon	0 - no modifier bypass	Check pair

95249 is bundled into these codes

95249 appears as a Column 2 code in 3 active edits. Reported with one of these Column 1 codes on the same date of service, 95249 is the code that denies.

Column 1 code	Short description
`0740T`	Rem auton alg nsln cal setup	Check pair
`0741T`	Rem auton alg nsln data coll	Check pair
`95250`	Cont gluc mntr phys/qhp eqp	Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.