Virginia · G9874

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 in Virginia

Virginia Medicare Avg
$112.70
7% above national avg
National Medicare Avg
$105.00
All states combined
Billed Charge (VA)
$210.00
What providers submit
Est. Commercial (VA)
$247.94
National avg: $235.19
Est. Cash / Self-Pay (VA)
$142.28
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

14
Services in VA
1
Providers
N/A
Min Payment
N/A
Max Payment

Top Providers in Virginia

Provider Medicare Services
Virginia Hospital Center Arlington... $112.70 14

Virginia Pricing in Context

In Virginia, CPT code G9874 (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) carries an average Medicare payment of $112.70 — 7% above the national benchmark of $105.00. 1 providers across the state submitted claims for this procedure in 2023, performing 14 total services. Individual payments in VA ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in Virginia is $210.00, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Virginia sits above the national Medicare average, commercial rates in the state may also run higher than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Temporary Procedures procedures, the estimated commercial insurance price in Virginia lands near $247.94, with self-pay cash prices typically around $142.28. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does 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 cost in Virginia?

The average Medicare payment for 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 in Virginia is $112.70, which is 7% above the national average of $105.00. Providers in VA typically bill $210.00 for this procedure.

What does 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 cost with insurance in Virginia?

With commercial insurance in Virginia, 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 costs an estimated $247.94. Without insurance, the estimated cash price is $142.28. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform 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 in Virginia?

1 providers in Virginia billed Medicare for 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 in 2023, performing 14 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is 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 cheaper in Virginia than the national average?

No — 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 costs 7% above the national average in Virginia. The state average Medicare payment is $112.70 compared to $105.00 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial