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See a sample rate comparisonHCPCS G9885 Fee Schedule
HCPCS G9885 is classified under Procedures / Professional Services, in the Additional Assorted Quality Measures subgroup.
Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 22-24 under the MDPP Expanded Model (EM). An ongoing maintenance session is an MDPP service that: (1) is furnished by an MDPP supplier during months 13 through 24 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 maintained at least 5% weight loss (WL) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 22-24.
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Additional Assorted Quality Measures |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for G9885 |
National average reimbursement for HCPCS G9885 by major payers:
$63.92
BCBS / Anthem
$64.71
UnitedHealthcare
$50.06
Aetna
$53.93
Cigna
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HCPCS G9885
5 of 25 sample ratesHigher to lower in this preview
Piedmont Newton Ekg Billing LLC
Piedmont Newton Hospital Inc
$130.50Published rateCabrini Sutherland
Surgical Specialists Of Charlotte, PA
$96.27Published rateMiguel A. Arenas, M.D., PC
Miguel A Arenas Md PC
$70.48Published rateTexas Radiology Associates LLP
Texas Radiology Associates, LLP
$55.00Published rateCindy Chang
Miguel A Arenas Md PC
$38.95Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G9885 vs. Other Additional Assorted Quality Measures Codes
The table lists codes related to G9885. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9884-HCPCS | Low | Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 19-21 under the MDPP Expanded Model (EM). An ongoing maintenance session is an MDPP service that: (1) is furnished by an MDPP supplier during months 13 through 24 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 maintained at least 5% weight loss (WL) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 19-21. |
| G9885-HCPCS | Low | Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 22-24 under the MDPP Expanded Model (EM). An ongoing maintenance session is an MDPP service that: (1) is furnished by an MDPP supplier during months 13 through 24 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 maintained at least 5% weight loss (WL) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 22-24. |
| G9890-HCPCS | Low | 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. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9885. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9885 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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