Physician Resources
Welcome! Our priority is to build strong relationships with both referring and new physician offices. Together, we strive to deliver the highest standard of care and support for every patient.
MedQ Order Forms

Refer a Patient Today

If your practice has patients who could benefit from supplies like CGMs, orthopedic braces, or mobility aids, you’re welcome to download and complete our fillable referral forms using the buttons below. Your own order form is also accepted.

For a faster, paperless process, you can send referrals through Parachute Health a secure electronic platform we support.

CGM
Back Brace
Ankle Brace
Wrist Brace
Knee Brace
Referral Form

Insurance Coverage Criteria for CGM

       To be eligible for coverage of a CGM and related supplies, the beneficiary must meet all of the following initial coverage criteria: 

  1. The beneficiary has diabetes mellitus (Refer to the ICD-10 code list in the LCD-related Policy Article for applicable diagnoses); 
  2. The beneficiary’s treating practitioner has concluded that the beneficiary (or beneficiary’s caregiver) has sufficient training using the CGM prescribed as evidenced by providing a prescription; and,
  3. The CGM is prescribed in accordance with its FDA indications for use; and,
  4. The beneficiary for whom a CGM is being prescribed, to improve glycemic control, meets at least one of the criteria below: -The beneficiary is insulin-treated; or, -The beneficiary has a history of problematic hypoglycemia with documentation of at least one of the following (see the POLICY SPECIFIC DOCUMENTATION REQUIREMENTS section of the LCD-related Policy Article (A52464)): 6. Within six (6) months prior to ordering the CGM, the treating practitioner has an in-person or Medicare-approved telehealth visit with the beneficiary to evaluate their diabetes control and determined that criteria (1)-(4) above are met. CGM Continued Coverage Every six (6) months following the initial prescription of the CGM, the treating practitioner conducts an in-person or Medicare-approved telehealth visit with the beneficiary to document adherence to their CGM regimen and diabetes treatment plan.