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Colorado 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
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.84 / $64.84 / $64.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.62 / $64.84 / $104.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.04 / $67.04 / $67.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.53 / $85.99 / $121.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.26 / $62.26 / $62.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.92 / $45.92 / $45.92
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.84 / $73.94 / $116.73
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.00 / $155.00 / $329.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.00 / $88.17 / $146.44