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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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.29 / $51.29 / $51.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $69.18 / $104.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $45.71 / $45.71
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $120.23 / $151.36
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $87.10 / $173.78
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $79.43 / $104.71
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.20 / $109.65 / $112.20
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.29 / $83.18 / $134.90
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $47.86 / $109.65
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $114.82 / $151.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $107.15 / $165.96