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Colorado 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
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.30 / $16.30 / $16.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.25 / $16.30 / $78.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.85 / $16.85 / $16.85
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.72 / $21.62 / $30.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.66 / $15.66 / $15.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.55 / $11.55 / $11.55
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.30 / $18.76 / $78.28
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.00 / $155.00 / $329.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $21.20 / $34.34