HCPCS G9875 Fee Schedule

Last Verified: January 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Nine total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP service that: (1) is furnished by an MDPP supplier during months 1 through 6 of the MDPP services period; (2) is approximately 1 hour in length; and (3) adheres to a CDC-approved DPP curriculum for core sessions

Key Fact	Detail
Service Type	• Procedures / Professional Services • Additional Assorted Quality Measures
Complexity Level	Low

National average reimbursement for HCPCS G9875 by major payers:

$113.97

$117.67

$133.39

$142.18

Preview provider-level rates for...

For billing codeHCPCS G9875

Payer	Code	Rate	NPI	Tax ID	State	Specialty
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS G9875
United	G9875	$125.01	1619087590 - MIGUEL ARENAS	300394179 - (AZ) MIGUEL A ARENAS MD PC	AZ	Gastroenterology Physician (207RG0100X)
United	G9875	$90.00	1396770004 - HOSPITAL AUTHORITY OF WASHINGTON COUNTY, WASHINGTON COUNTY REGIONAL MEDICAL CENTER	586012329 - (GA) HOSPITAL AUTHORITY OF WASHINGTON COUNTY	GA	Rural Acute Care Hospital (282NR1301X)
United	G9875	$125.01	1548859895 - ALICIA ENCINAS	300394179 - (AZ) MIGUEL A ARENAS MD PC	CA	Family Nurse Practitioner (363LF0000X)
United	G9875	$100.80	1720189517 - TAYLOR REGIONAL HOSPITAL	580655369 - (GA) TAYLOR REGIONAL HOSPITAL	GA	Rural Acute Care Hospital (282NR1301X)
United	G9875	$106.19	1942682653 - RABIA JAMY	752654757 - TEXAS NEUROLOGY, P. A.	TX	Neurology Physician (2084N0400X)
United	G9875	$130.50	1356552350 - REDMOND PARK HOSPITAL LLC, REDMOND HOSPITAL BASED SERVICES LLC	201017054 - (GA) REDMOND PARK HOSPITAL LLC	GA	General Acute Care Hospital (282N00000X)
United	G9875	$206.80	1073502985 - CHU CHEN	42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.	MA	Pediatrics Physician (208000000X)
United	G9875	$96.81	1790057420 - BAMA HEART DOC, P.C., ALABAMA HEART AND VASCULAR MEDICINE	451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE	AL	Interventional Cardiology Physician (207RI0011X)
United	G9875	$262.42	1396769964 - JULIE WEBSTER	853861695 - MUSC COMMUNITY PHYSICIANS	SC	Body Imaging Physician (2085B0100X)
United	G9875	$197.40	1073502985 - CHU CHEN	42484572	MA	Pediatrics Physician (208000000X)
United	G9875	$76.50	1578583647 - MARC STIEFEL	202604678 - PINNACLE ENT ALLIANCE, LLC	PA	Otolaryngology Physician (207Y00000X)
United	G9875	$111.94	1801844469 - AUGUSTA VAMC	582089405 - AUGUSTA VAMC	GA	General Acute Care Hospital (282N00000X)
United	G9875	$100.80	1497064679 - JENKINS COUNTY HOSPITAL LLC, OPTIM MEDICAL CENTER - JENKINS	273100894	GA	Critical Access Hospital (282NC0060X)
United	G9875	$99.00	1235162751 - TEXAS RADIOLOGY ASSOCIATES LLP	751459885 - TEXAS RADIOLOGY ASSOCIATES, LLP	TX	Diagnostic Radiology Physician (2085R0202X)
United	G9875	$125.01	1548859895 - ALICIA ENCINAS	300394179 - (AZ) MIGUEL A ARENAS MD PC	CA	Family Nurse Practitioner (363LF0000X)
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist

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HCPCS G9875 vs. Other Additional Assorted Quality Measures Codes

The HCPCS G9875 code is part of the Procedures / Professional Services services used for Additional Assorted Quality Measures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The HCPCS G9875 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

Code	Complexity	Description
G9874-HCPCS	Low	Four total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP service that: (1) is furnished by an MDPP supplier during months 1 through 6 of the MDPP services period; (2) is approximately 1 hour in length; and (3) adheres to a CDC-approved DPP curriculum for core sessions.
G9875-HCPCS	Low	Nine total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP service that: (1) is furnished by an MDPP supplier during months 1 through 6 of the MDPP services period; (2) is approximately 1 hour in length; and (3) adheres to a CDC-approved DPP curriculum for core sessions
G9876-HCPCS	Low	Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP Expanded Model (EM). A core maintenance session is an MDPP service that: (1) is furnished by an MDPP supplier during months 7 through 12 of the MDPP services period; (2) is approximately 1 hour in length; and (3) adheres to a CDC-approved DPP curriculum for maintenance sessions. The beneficiary did not achieve at least 5% weight loss (WL) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 7-9.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9875. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the G9875 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules

Medicare & Medicaid Rates

Government-set reimbursement amounts

Private Insurance Rates

Negotiated rates between providers and insurance companies

Geographic Location

Costs may be higher in urban areas.

Provider Type

Hospital providers may have different rates than private practice.

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