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Massachusetts 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
$51.60 / $51.60 / $51.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.20 / $55.44 / $95.95
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.31 / $306.38 / $306.38
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $98.16 / $362.37
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 / $65.97
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.94 / $77.94 / $91.70
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.40 / $135.60 / $173.60
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.31 / $306.38 / $306.38
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $98.16 / $362.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.60 / $84.00 / $192.46