go back

Washington 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 $83 · 10th–90th $52–$1290%10%10th90th$83Professionalmedian $78 · 10th–90th $47–$1200%10%10th90th$78$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
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $45.71
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $67.61 / $104.71
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $102.33 / $141.25
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
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $77.62 / $138.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $77.62 / $128.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $79.43
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $109.65 / $109.65
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $87.10 / $147.91
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $97.72 / $141.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $38.90 / $38.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $87.10 / $158.49
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $190.55