G9877 Medicaid reimbursement rate by state (2026)
Two medicare diabetes prevention program. Medicaid pays a median of $18.53 for G9877 across 5 states, from $12.00 in California to $76.00 in Michigan.
- States publishing
- 5
- National median
- $18.53units vary by state
- Lowest
- $12.00California
- Highest
- $76.00Michigan
What does Medicaid pay for G9877?
5 state Medicaid programs publish a fee-for-service rate for G9877. The national median is $18.53 (units differ between states). Michigan pays the most, $76.00, and California the least, $12.00, a 6.3x spread.
G9877 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.
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 G9877, 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 G9877, 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 G9877, so each amount is a flat payment for one service as the code defines it.
- Per hour. G9877 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 G9877, 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.
Why G9877 rates differ between states
Published rates for G9877 run from $12.00 in California to $76.00 in Michigan, a 6.3x gap in the same unit. Half the states pay more than the median of $18.53 and half pay less. The usual reasons for a spread like this in other rates:
- States pay different amounts by provider type, setting and program, and the published rate may already include or exclude add-ons that another state pays separately.
- Rate studies, settlements and targeted increases for workforce shortages move individual services out of step with the rest of a state's schedule.
- 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.
Timing matters too. 1 state set the current rate for G9877 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.
What managed-care plans pay for G9877
No managed-care plan publishes what it pays for G9877. What is public is the rule each state's plan contracts set, and that rule decides how much the published rate matters when you contract with a plan.
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.
Units and billing for G9877
G9877 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.
Frequently asked questions
What does Medicaid pay for G9877?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $18.53. Michigan pays the most ($76.00) and California the least ($12.00).
Which state pays the highest Medicaid rate for G9877?
Michigan, at $76.00, effective 2023-07-01.
Which state pays the lowest Medicaid rate for G9877?
California, at $12.00, effective 2026-10-01.
What unit is G9877 billed in?
None of the 5 schedules prints a separate unit for G9877, so each amount is a flat payment for one service as the code defines it.
Do managed-care plans pay the same rate for G9877?
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.