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Minnesota 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 $102 · 10th–90th $60–$5890%10%10th90th$102Professionalmedian $60 · 10th–90th $48–$1050%50%10th90th$60$50.0$100.0$200.0$500.0$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
$102.33 / $102.33 / $102.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $74.13 / $104.71
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $478.63
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $60.26 / $60.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $323.59 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $114.82 / $141.25
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $363.08 / $707.95
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $117.49
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $89.13 / $190.55
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $104.71 / $331.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $79.43 / $165.96