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

Pennsylvania 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 $63 · 10th–90th $63$630%50%$63Professionalmedian $18 · 10th–90th $12$740%10%20%10th90th$18$10.0$20.0$50.0$100.0

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
$63.10
Median
$63.10
Typical High
$72.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$11.48
Median
$38.90
Typical High
$75.86
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
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$18.62
Typical High
$18.62
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$63.10
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$44.67
Typical High
$75.86
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$158.49
United
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$15.49
Typical High
$26.92