Diabetes is the eighth leading cause of death in the U.S., and individuals living with diabetes face serious disease-related complications. Moreover, diabetes disproportionately impacts Medicaid beneficiaries when compared to the general public, with enrollees experiencing higher rates of poor diabetes management, worse glycemic outcomes, and greater barriers to care. These challenges often result in increased complications, such as kidney disease, lower-limb amputations, and cardiovascular issues.

Continuous glucose monitors (CGMs) are the standard of care for people with type 1 diabetes, and a recommended tool for people with type 2 diabetes who use insulin, take noninsulin treatments that can cause hypoglycemia, or could benefit from a CGM to support self-management. CGMs have been shown to: (1) improve clinical quality, health outcomes, and quality of life; (2) reduce health care costs; and (3) support broader efforts by state Medicaid agencies to address disparities and related health inequities.

As of July 2026, 48 states and D.C. provide some level of CGM fee-for-service coverage — an increase from 45 states and D.C. in May 2023. Yet, there is no consistent CGM policy across states, with coverage varying significantly. This fact sheet outlines current policies related to CGM coverage within Medicaid and why expanding access to CGMs in Medicaid can improve diabetes care and reduce health disparities. The fact sheet provides an update to a CHCS state-by-state coverage analysis from 2022, and includes steps taken by states to reduce barriers to CGM access in Medicaid.