go back

Montana rates for HCPCS G9890

Bridge Payment: A one-time payment for the first Medicare Diabetes Prevention Program (MDPP) core session, core maintenance session, or ongoing maintenance session furnished by an MDPP supplier to an MDPP beneficiary during months 1-24 of the MDPP Expanded Model (EM) who has previously received MDPP services from a different MDPP supplier under the MDPP Expanded Model. A supplier may only receive one bridge payment per MDPP beneficiary

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.25 / $28.50 / $39.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.28 / $36.28 / $36.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.79 / $36.28 / $36.28
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.98 / $35.00 / $42.77
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.32 / $33.49 / $43.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.01 / $43.39 / $61.35