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Minnesota 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
$76.76 / $76.76 / $76.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.39 / $70.00 / $94.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.70 / $15.00 / $77.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.00 / $14.55 / $15.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$171.43 / $245.33 / $537.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.00 / $92.40 / $106.68
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$148.56 / $220.19 / $506.80
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.00 / $84.00 / $89.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.95 / $25.77 / $129.72
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.20 / $30.75 / $91.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.00 / $29.40 / $54.90