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Oregon 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 $110 · 10th–90th $65–$1120%20%40%10th90th$110Professionalmedian $79 · 10th–90th $48–$1170%10%10th90th$79$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 / $69.18 / $104.71
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 / $47.86
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $120.23 / $144.54
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $83.18 / $144.54
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $79.43 / $107.15
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $109.65 / $109.65
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $83.18 / $141.25
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $47.86 / $109.65
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $117.49 / $154.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $107.15 / $162.18