go back

Virginia 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 $72 · 10th–90th $55–$1200%20%10th90th$72Professionalmedian $68 · 10th–90th $46–$1020%10%20%10th90th$68$0.0$0.2$2.0$20.0$200.0$2.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $67.61
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $69.18 / $104.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $26.92
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
$52.48 / $66.07 / $97.72
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $87.10 / $138.04
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $50.12
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $69.18 / $102.33
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $69.18 / $102.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $57.54 / $77.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $64.57 / $107.15