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Nebraska 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
$101.00 / $101.00 / $101.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.60 / $101.00 / $125.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.62 / $140.49 / $140.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.63 / $50.14 / $50.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.69 / $95.00 / $139.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.85 / $151.50 / $191.90
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.39 / $126.00 / $362.37
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.69 / $90.92 / $139.69
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.69 / $91.36 / $139.69
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
$100.80 / $126.00 / $240.89