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Wisconsin 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
$36.31 / $36.31 / $36.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $33.88 / $38.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.18 / $79.43 / $128.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $36.31 / $48.98
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.38 / $35.48 / $46.77
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.38 / $35.48 / $46.77
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $46.77 / $151.36
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $58.88 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $37.15 / $72.44
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.65 / $43.65 / $151.36
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $117.49 / $151.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $40.74 / $95.50