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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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.01 / $102.01 / $102.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.29 / $93.00 / $125.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.80 / $60.00 / $310.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.00 / $58.20 / $60.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$228.06 / $326.38 / $714.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.75 / $122.93 / $141.91
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$197.63 / $292.93 / $674.23
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.75 / $111.75 / $119.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.00 / $99.67 / $172.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $127.89 / $283.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $120.00 / $230.58