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Idaho 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
$12.34 / $12.34 / $12.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.10 / $16.50 / $72.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.55 / $11.55 / $11.55
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.39 / $65.80 / $78.95
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $55.00 / $3,900.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.77 / $20.90 / $21.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.75 / $20.78 / $27.85