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Nationwide rates for HCPCS G9877

Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 10-12 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 10-12

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.65 / $17.10 / $19.55	Facility	$15.65	$17.10	$19.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.39 / $18.89 / $76.76	Professional	$11.39	$18.89	$76.76
BCBS Facility/Professional Facility Modifier Low / Median / High Price $16.85 / $16.85 / $16.85	Facility	$16.85	$16.85	$16.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.77 / $6.77 / $16.77	Professional	$6.77	$6.77	$16.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $15.66 / $15.66 / $15.66	Facility	$15.66	$15.66	$15.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.55 / $11.55 / $11.55	Professional	$11.55	$11.55	$11.55
United Facility/Professional Professional Modifier Low / Median / High Price $13.00 / $17.32 / $31.37	Professional	$13.00	$17.32	$31.37

Nationwide rates for HCPCS G9877

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