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Utah 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
$30.90 / $30.90 / $30.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $26.92 / $38.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $19.05 / $28.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $44.67 / $60.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $29.51 / $34.67
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $45.71 / $45.71
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.91 / $31.62 / $33.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $29.51 / $42.66