go back

Montana 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 $95 · 10th–90th $52–$1150%20%10th90th$95Professionalmedian $76 · 10th–90th $48–$1050%10%10th90th$76$50.0$100.0$200.0

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
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $74.13 / $102.33
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 / $89.13
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $95.50 / $100.00
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $95.50 / $100.00
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $77.62 / $141.25
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $79.43 / $89.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $93.33 / $117.49