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Georgia 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
$13.20 / $13.20 / $15.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.39 / $14.94 / $76.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.43 / $13.39 / $33.21
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 / $28.71
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.11 / $15.11 / $52.81
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.50 / $157.50 / $157.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.50 / $18.87 / $30.15