K0554 HCPCS code: Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system

K0554 is the HCPCS Level II code for receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system. CMS terminated K0554 on 2022-12-31; do not bill it for later dates of service. In 2023 Medicare paid an average of $72.38 per service for K0554 across 37 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. Medicare volume fell 100% from 2022 to 2023 (306,906 to 37 services). In 2023, 8 suppliers billed Medicare for K0554 (purchases), serving 37 beneficiaries.

Code details

Who bills K0554 (2023)

Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.

Medicare utilization for K0554, 2022–2023

Medicare policy articles for this code

• A52464: Glucose Monitor - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
• A52507: External Infusion Pumps - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance

Covered diagnoses (495 ICD-10-CM codes)

The diagnoses most often listed as covered in the policy articles above:

Showing 10 of 495. The full list, non-covered diagnoses and CSV export are in Caduvo.

What changed for K0554

• 2017-07-01: K0554 added to HCPCS Level II
• Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01

Frequently asked questions

What is HCPCS code K0554?

K0554 is the HCPCS Level II code for receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system. Short descriptor: "Ther cgm receiver/monitor".

How much does Medicare pay for K0554?

In 2023, the average Medicare payment was $72.38 per service (average allowed $93.02).

Does Medicare cover K0554?

Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.

Which diagnoses support coverage for K0554?

Medicare policy articles that cite K0554 list 495 covered ICD-10-CM diagnosis codes across 2 articles. The most cited include E08.00 (Diabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)), E08.01 (Diabetes mellitus due to underlying condition with hyperosmolarity with coma), E08.10 (Diabetes mellitus due to underlying condition with ketoacidosis without coma). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.

Related K05 codes

• K0552 — Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each ($3.47–$3.96)
• K0553 — Supply allowance for therapeutic continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service

Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.

Next steps

• Run a reimbursement report for a device billed under K0554
• Watch K0554 for fee, coverage and descriptor changes
• Build a full Medicare revenue model for K0554

Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.

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