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Iowa 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
Professional
Modifier
Low / Median / High Price
$55.44 / $101.00 / $125.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.92 / $102.54 / $214.77
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.26 / $125.24 / $206.65
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.30 / $128.22 / $362.37
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.69 / $95.00 / $139.69
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.53 / $95.00 / $152.08
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.20 / $121.20 / $209.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.80 / $110.55 / $173.40