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New Hampshire rates for HCPCS G9876

Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP Expanded Model (EM). A core maintenance session is an MDPP service that: (1) is furnished by an MDPP supplier during months 7 through 12 of the MDPP services period; (2) is approximately 1 hour in length; and (3) adheres to a CDC-approved DPP curriculum for maintenance sessions. The beneficiary did not achieve at least 5% weight loss (WL) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 7-9

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.13 / $14.13 / $14.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $15.85 / $75.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.48 / $11.48 / $11.48
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $21.88 / $36.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $20.42 / $38.02
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $3,388.44 / $4,168.69