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

South Dakota 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 $85 · 10th–90th $15$1580%10%10th90th$85Professionalmedian $76 · 10th–90th $11$930%10%20%10th90th$76$1.0$5.0$20.0$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$15.14
Median
$15.14
Typical High
$15.14
Aetna
Setting
Professional
Modifier
Global
Typical Low
$11.48
Median
$77.62
Typical High
$93.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$83.18
Typical High
$104.71
Medica
Setting
Facility
Modifier
Global
Typical Low
$14.45
Median
$85.11
Typical High
$169.82
Medica
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$22.39
Typical High
$91.20
Midlands
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$22.91
Typical High
$32.36
Midlands
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$18.62
Typical High
$18.62
United
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$18.20
Typical High
$30.90
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$1.00
Median
$1.00
Typical High
$1.00