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South Dakota 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
Facility
Modifier
Low / Median / High Price
$38.38 / $38.38 / $38.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.50 / $27.75 / $38.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.50 / $35.63 / $35.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.50 / $38.00 / $54.34
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.12 / $48.20 / $149.71
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.73 / $37.56 / $52.99
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.20 / $37.56 / $57.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.50 / $48.20 / $62.50
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00