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Nationwide rates for HCPCS G9878

Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 7-9 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 achieved 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 7-9

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $63.10 / $102.33	Facility	$44.67	$63.10	$102.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $67.61 / $104.71	Professional	$45.71	$67.61	$104.71
BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Facility	$67.61	$67.61	$67.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $0.03 / $53.70 / $125.89	Professional	$0.03	$53.70	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $363.08	Facility	$87.10	$87.10	$363.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $45.71 / $112.20	Professional	$45.71	$45.71	$112.20
United Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $51.29 / $75.86	Facility	$36.31	$51.29	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $66.07 / $117.49	Professional	$48.98	$66.07	$117.49

Nationwide rates for HCPCS G9878

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