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Texas 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

Facilitymedian $28 · 10th–90th $19–$470%10%10th90th$28Professionalmedian $28 · 10th–90th $19–$380%10%10th90th$28$0.5$2.0$10.0$50.0

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
$19.05 / $21.88 / $28.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $28.18 / $38.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $19.50 / $19.50
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $194.98 / $194.98
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $28.18 / $41.69
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $28.18 / $38.02
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $28.18 / $40.74
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $19.50 / $19.50
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.25 / $0.25 / $0.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $27.54 / $40.74
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $30.90