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Florida 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

Facilitymedian $51 · 10th–90th $39–$600%50%10th90th$51Professionalmedian $58 · 10th–90th $40–$1000%20%10th90th$58$0.1$0.5$2.0$10.0$50.0$200.0$1.0K

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
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $51.29 / $60.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $58.88 / $100.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $87.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $47.86 / $47.86
Florida Blue
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $47.86 / $61.66
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $50.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.06 / $47.86 / $60.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $60.26 / $102.33
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $26.92 / $100.00