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South Dakota 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
$102.01 / $102.01 / $102.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.44 / $102.01 / $112.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.92 / $111.75 / $139.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.45 / $189.47 / $307.18
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $113.40 / $362.37
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.69 / $95.00 / $128.22
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.31 / $90.92 / $102.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.55 / $100.80 / $132.30