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Washington 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
$19.05 / $19.05 / $19.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $25.12 / $38.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $19.05 / $19.05
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.88 / $28.84 / $48.98
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $28.84 / $45.71
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $50.12 / $79.43
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.02 / $45.71 / $45.71
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.62 / $31.62 / $31.62
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $36.31 / $57.54
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $38.90 / $57.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $38.90 / $93.33
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $25.12 / $47.86