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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

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	Facility/Professional	Typical Low	Median	Typical High
Aetna Facility/Professional Facility Modifier Typical Low / Median / Typical High $44.67 / $67.61 / $102.33	Facility	$44.67	$67.61	$102.33
Aetna Facility/Professional Professional Modifier Typical Low / Median / Typical High $45.71 / $67.61 / $104.71	Professional	$45.71	$67.61	$104.71
BCBS Facility/Professional Facility Modifier Typical Low / Median / Typical High $67.61 / $67.61 / $67.61	Facility	$67.61	$67.61	$67.61
BCBS Facility/Professional Professional Modifier Typical Low / Median / Typical High $0.03 / $53.70 / $125.89	Professional	$0.03	$53.70	$125.89
Cigna Facility/Professional Facility Modifier Typical Low / Median / Typical High $87.10 / $87.10 / $416.87	Facility	$87.10	$87.10	$416.87
Cigna Facility/Professional Professional Modifier Typical Low / Median / Typical High $47.86 / $47.86 / $112.20	Professional	$47.86	$47.86	$112.20
United Facility/Professional Facility Modifier Typical Low / Median / Typical High $38.90 / $53.70 / $72.44	Facility	$38.90	$53.70	$72.44
United Facility/Professional Professional Modifier Typical Low / Median / Typical High $48.98 / $66.07 / $120.23	Professional	$48.98	$66.07	$120.23

Nationwide rates for HCPCS G9878

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