HCPCS code G9875
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
What G9875 means
G9875 (9 em core sessions) belongs to the HCPCS Level II G series (Procedures / Professional Services (Temporary)). Its Medicare coverage status is Carrier judgment. Medicare coverage is left to the judgment of the local Medicare Administrative Contractor (MAC), so check your MAC's local coverage determinations.
Part B pricing: Service not separately priced by Part B (e.g., services not covered, bundled, used by part a only, etc.).
Code details
- Short description
- 9 em core sessions
- Coverage code
- C = Carrier judgment
- Pricing indicator
- 00 = Service not separately priced by Part B (e.g., services not covered, bundled, used by part a only, etc.)
- Multiple pricing indicator
- 9 = Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established(pricing indicator is '99')
- Type of service
- 1 = Medical care
- Action code
- N = No maintenance for this code
- Action effective date
- April 01, 2018
- Code added date
- April 01, 2018
- Data year
- 2026
Questions about G9875
What is HCPCS code G9875?
HCPCS code G9875 is a Level II code in the G series (Procedures / Professional Services (Temporary)). Its full description is: "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"
Is G9875 a CPT code?
No. G9875 is a HCPCS Level II code maintained by CMS, not a CPT (Level I) code from the American Medical Association. People often search for it as a CPT code because both code sets are reported on the same claims.
Does Medicare cover HCPCS code G9875?
The Medicare coverage code for G9875 is "Carrier judgment". Medicare coverage is left to the judgment of the local Medicare Administrative Contractor (MAC), so check your MAC's local coverage determinations.
When was HCPCS code G9875 added?
G9875 was added to the HCPCS code set on April 01, 2018. The most recent action on it (No maintenance for this code) took effect on April 01, 2018.
Nearby G codes
All G codes- G9869Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, 10-20 minutes
- G9870Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, more than 20 minutes
- G9871Behavioral counseling for diabetes prevention, online, 60 minutes
- G9873First medicare diabetes prevention program (mdpp) core session was 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
- G9874Four 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
- G9876Two 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
- G9877Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 10-12 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 10-12
- G9878Two 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 achieved 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
- G9879Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 10-12 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 achieved 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 10-12
- G9880The mdpp beneficiary achieved at least 5% weight loss (wl) from his/her baseline weight in months 1-12 of the mdpp services period under the mdpp expanded model (em). this is a one-time payment available when a beneficiary first achieves at least 5% weight loss from baseline as measured by an in-person weight measurement at a core session or core maintenance session