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Billing code G9879 · Other

G9879 Medicaid reimbursement rate by state (2026)

Two medicare diabetes prevention program. Medicaid pays a median of $50.00 for G9879 across 5 states, from $18.53 in Wyoming to $101.00 in Michigan.

Data as of Oct 5, 20265 statesEvery rate links to its official source

States publishing
5
National median
$50.00units vary by state
Lowest
$18.53Wyoming
Highest
$101.00Michigan
Answer

What does Medicaid pay for G9879?

5 state Medicaid programs publish a fee-for-service rate for G9879. The national median is $50.00 (units differ between states). Michigan pays the most, $101.00, and Wyoming the least, $18.53, a 5.5x spread.

State ranking

G9879 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 5 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Michigan Source · since 2023-07-01$101.00——Plans negotiate; applies out of network—
2Idaho Source · since 2025-09-01$54.43——Not classified—
3Illinois Source · since 2021-08-01$50.00——Plans negotiate; applies out of network—
See all 5 states for G9879 — start free

2 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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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; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track G9879 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

How to read this table

  • Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for G9879, so the order is by published amount and is not a like-for-like rank.
  • Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 1 of the 5 states list more than one rate for G9879, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
  • Unit. None of the 5 schedules prints a separate unit for G9879, so each amount is a flat payment for one service as the code defines it.
  • Per hour. G9879 is not billed in time units in these states, so no hourly figure is shown.
  • Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
  • % of Medicare. No Medicare physician fee schedule amount is on file for G9879, so there is no percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why G9879 rates differ between states

Published rates for G9879 run from $18.53 in Wyoming to $101.00 in Michigan, a 5.5x gap in the same unit. Half the states pay more than the median of $50.00 and half pay less. The usual reasons for a spread like this in other rates:

  • Each state sets its own fee schedule and updates it on its own budget cycle, so two states can price the same service from different base years.
  • Rate studies, settlements and targeted increases for workforce shortages move individual services out of step with the rest of a state's schedule.
  • Some states tie their rates to a percentage of a Medicare amount; others keep a schedule of their own that changes only when the legislature funds an increase.

Timing matters too. 1 state set the current rate for G9879 in 2026 or later, while 2 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

Managed care

What managed-care plans pay for G9879

What a plan pays for G9879 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 5 states.

In 3 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 2 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (3 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Michigan managed care.

Billing

Units and billing for G9879

G9879 is a HCPCS Level II professional services code in the other line, billed mostly by providers. G codes describe professional services and procedures that have no CPT code, or that payers define more narrowly. Many are timed, so check the unit before comparing.

This service is billed in the unit the state's schedule defines.

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.

FAQ

Frequently asked questions

What does Medicaid pay for G9879?

It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $50.00. Michigan pays the most ($101.00) and Wyoming the least ($18.53).

Which state pays the highest Medicaid rate for G9879?

Michigan, at $101.00, effective 2023-07-01.

Which state pays the lowest Medicaid rate for G9879?

Wyoming, at $18.53, effective 2021-01-01.

What unit is G9879 billed in?

None of the 5 schedules prints a separate unit for G9879, so each amount is a flat payment for one service as the code defines it.

Do managed-care plans pay the same rate for G9879?

Not necessarily. In 3 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 2 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.