go back

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.25 / $11.25 / $15.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.35 / $15.00 / $76.00
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
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.49 / $13.38 / $15.64
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $40.00 / $50.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.80 / $15.00 / $24.25
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.77 / $6.77 / $6.77