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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.20 / $68.20 / $95.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.20 / $68.20 / $95.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $26.89
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.15 / $66.44 / $96.59
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.60 / $74.34 / $127.61
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.00 / $98.05 / $131.28
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.99 / $70.75 / $107.80
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.99 / $70.75 / $107.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.18 / $66.78 / $111.88