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MDPP Core Maintenance, Months 10-12, Under 5% Weight Loss

New York 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

Rates data updated July 2026.

Facilitymedian $56 · 10th–90th $8$630%50%10th90th$56Professionalmedian $15 · 10th–90th $8$720%10%20%10th90th$15$0.0$0.1$0.5$2.0$10.0$50.0$200.0

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
Setting
Facility
Modifier
Global
Typical Low
$7.94
Median
$56.23
Typical High
$63.10
Aetna
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$16.60
Typical High
$72.44
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.02
Median
$0.03
Typical High
$6.76
Cigna
Setting
Facility
Modifier
Global
Typical Low
$19.05
Median
$19.05
Typical High
$19.05
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$12.02
Typical High
$12.02
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$12.88
Median
$12.88
Typical High
$15.49
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$15.14
Typical High
$31.62
United
Setting
Facility
Modifier
Global
Typical Low
$15.14
Median
$15.14
Typical High
$15.14
United
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$15.14
Typical High
$38.02
Univera
Setting
Facility
Modifier
Global
Typical Low
$11.22
Median
$14.79
Typical High
$15.49
Univera
Setting
Professional
Modifier
Global
Typical Low
$11.22
Median
$14.79
Typical High
$25.12