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Florida 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

Facilitymedian $13 · 10th–90th $9–$150%50%10th90th$13Professionalmedian $15 · 10th–90th $10–$720%20%10th90th$15$0.0$0.2$2.0$20.0$200.0$2.0K

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
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.91 / $12.88 / $15.14
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $15.14 / $75.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.88 / $21.88 / $21.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $12.02
Florida Blue
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $12.02 / $15.49
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $50.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $12.02 / $15.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.72 / $15.14 / $25.12
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.76 / $6.76 / $75.86