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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 $61.50 / $66.52 / $74.99	Facility	$61.50	$66.52	$74.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.62 / $68.20 / $102.01	Professional	$46.62	$68.20	$102.01
BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.04 / $67.04 / $67.04	Facility	$67.04	$67.04	$67.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.89 / $26.89 / $66.66	Professional	$26.89	$26.89	$66.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.26 / $62.26 / $62.26	Facility	$62.26	$62.26	$62.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.92 / $45.92 / $45.92	Professional	$45.92	$45.92	$45.92
United Facility/Professional Professional Modifier Low / Median / High Price $54.00 / $72.00 / $129.72	Professional	$54.00	$72.00	$129.72

Nationwide rates for HCPCS G9878

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