G9875 Medicaid reimbursement rates by state
Nine total medicare diabetes prevention program. 5 state Medicaid programs publish a fee-for-service rate for G9875. Rates run from $18.53 in Wyoming to $191.00 in Michigan, with a median of $81.22.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 5
- Median rate
- $81.22units vary by state
- Highest
- $191.00Michigan
- Medicare (non-facility)
- —not on the physician fee schedule
G9875 rate in every state
One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $191.00since 2023-07-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Michigan Diabetes Prevention Progr |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $140.00since 2021-08-01 | — | — | Plans negotiate; applies out of network | — | HFS Diabetes Prevention and Management F |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $81.22since 2025-09-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $72.00since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health) | $18.53since 2021-01-01 | — | — | Not classified | — | Wyoming Medicaid Downloadable Fee Schedu |
Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.
Frequently asked questions
What does Medicaid pay for G9875?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $81.22. Michigan pays the most ($191.00) and Wyoming the least ($18.53).
Which state pays the highest Medicaid rate for G9875?
Michigan, at $191.00, effective 2023-07-01.
Do managed-care plans pay the same rate for G9875?
Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The table shows the rule for each state, cited to the contract or statute.