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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

Facilitymedian $76 · 10th–90th $15–$3160%10%10th90th$76Professionalmedian $15 · 10th–90th $12–$760%50%10th90th$15$10.0$20.0$50.0$100.0$200.0$500.0

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
$75.86 / $75.86 / $75.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $51.29 / $77.62
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $120.23
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $15.14 / $15.14
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $245.47 / $676.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $85.11 / $107.15
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $269.15 / $524.81
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $87.10
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.80 / $26.92 / $128.82
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $25.70 / $91.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $19.50 / $39.81