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New Mexico 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
Professional
Modifier
Low / Median / High Price
$46.62 / $71.61 / $111.60
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 / $45.92
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $60.00 / $1,500.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.29 / $77.40 / $112.14
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.92 / $45.92 / $2,250,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.33 / $89.03 / $134.33