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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

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier	Facility/Professional	Typical Low	Median	Typical High
Aetna Facility/Professional Facility Modifier Typical Low / Median / Typical High $10.96 / $15.85 / $75.86	Facility	$10.96	$15.85	$75.86
Aetna Facility/Professional Professional Modifier Typical Low / Median / Typical High $10.96 / $38.02 / $77.62	Professional	$10.96	$38.02	$77.62
BCBS Facility/Professional Facility Modifier Typical Low / Median / Typical High $16.98 / $16.98 / $16.98	Facility	$16.98	$16.98	$16.98
BCBS Facility/Professional Professional Modifier Typical Low / Median / Typical High $0.03 / $13.49 / $31.62	Professional	$0.03	$13.49	$31.62
Cigna Facility/Professional Facility Modifier Typical Low / Median / Typical High $21.88 / $21.88 / $309.03	Facility	$21.88	$21.88	$309.03
Cigna Facility/Professional Professional Modifier Typical Low / Median / Typical High $12.02 / $12.02 / $66.07	Professional	$12.02	$12.02	$66.07
United Facility/Professional Facility Modifier Typical Low / Median / Typical High $9.77 / $13.49 / $18.20	Facility	$9.77	$13.49	$18.20
United Facility/Professional Professional Modifier Typical Low / Median / Typical High $12.02 / $16.60 / $30.20	Professional	$12.02	$16.60	$30.20

Nationwide rates for HCPCS G9877

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