Medicare Diabetes Prevention Program (MDPP) 2025 Changes

The MDPP Expanded Model is intended to prevent Medicare beneficiaries with an indication of prediabetes from developing diabetes. Prevention of diabetes among this high-risk group of Medicare beneficiaries is expected to result in significant cost savings to the Medicare program.

Effective January 1, 2025, CMS has removed the MDPP bridge payment (HCPCS code G9890) from the 2025 fee schedule and updated the payment rates. Claims will be denied for HCPCS code G9890 for dates of service on or after January 1, 2025.

Additional updates can be found in the Medicare Diabetes Prevention Program Expanded Model MLN Booklet (MLN34893002).

CY 2025 Payment Rates HCPCS

G-Code Payment Description CY 2025
G9886 Behavioral counseling for diabetes prevention, in-person, group, 60 minutes $26
G9887 Behavioral counseling for diabetes prevention, distance learning, group, 60 minutes $26
G9880 5% WL Achieved from baseline weight $149
G9881 9% WL Achieved from baseline weight $26
G9888 Maintenance 5% WL from baseline weight in months 7-12 $8
G9890 Bridge Payment ** N/A

Reference

CR 13712 - Updating Calendar Year (CY) 2025 Medicare Diabetes Prevention Program (MDPP) Inflation Payment Rates

Last Updated Mar 24 , 2025