HCPCS G9875: MDPP Nine Core Sessions (Expanded Model)

HCPCS Level II code G9875 documents attendance at nine Medicare Diabetes Prevention Program (MDPP) core sessions under the MDPP Expanded Model (EM); the service is a CDC-approved core diabetes prevention session delivered by an MDPP supplier during months 1–6 of the MDPP service period, typically a group-based or virtual behavioral intervention session approximately one hour in length provided in outpatient community or virtual settings.

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HCPCS G9875: MDPP Nine Core Sessions (Expanded Model)

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Get alerted when payer policies referencing G9875 are released or updated.

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Clinical & Coding Specifications

Clinical Context

A Medicare beneficiary with prediabetes (impaired fasting glucose or elevated A1c not meeting diabetes thresholds) enrolls in the Medicare Diabetes Prevention Program (MDPP) Expanded Model (EM). The beneficiary attends a series of CDC-recognized core sessions delivered by an MDPP supplier during months 1–6 of the MDPP services period. After initial intake and baseline risk assessment (including weight, BMI, and hemoglobin A1c or fasting glucose documentation if available), the beneficiary participates in weekly group or virtual MDPP core sessions, each approximately one hour long. This claim represents attendance at the ninth core session.

Workflow:

The beneficiary is referred by a primary care clinician or self-enrolls with an MDPP supplier.
During the intake visit, the supplier documents eligibility, baseline measurements, and obtains informed consent for program participation.
The supplier delivers CDC-approved DPP curriculum content in scheduled one-hour core sessions (weeks 1–9+), recording attendance for each session.
After the ninth session, the supplier records the attendance event and bills G9875 to Medicare under the MDPP Expanded Model. Attendance records and supporting documentation (session date, duration ~1 hour, curriculum adherence, and beneficiary identity) are retained for audit and quality reporting.
Ongoing data collection continues for behavior change metrics (weight loss, physical activity) and continued sessions beyond month 6 as applicable.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99406`	Smoking and tobacco use cessation counseling visit, intermediate, greater than 3 minutes up to 10 minutes	May be provided in primary care visits preceding or concurrent with MDPP enrollment for behavioral risk counseling.

| 99407 | Smoking and tobacco use cessation counseling visit, intensive, greater than 10 minutes | Similar relation as 99406 when more intensive counseling occurs during clinical visits tied to lifestyle change.

| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | May be used by clinicians for weight management counseling that complements MDPP sessions.

| 96127 | Brief emotional/behavioral assessment (e.g., PHQ-2, PHQ-9) | Used to screen for depression or behavioral barriers before or during MDPP participation.

| 99401 | Preventive medicine counseling, individual, approximately 15 minutes (historical — replaced by newer codes in some payers) | Represents preventive counseling services that may be documented in primary care visits related to lifestyle change; use per payer policy.

Related Modifiers

5 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
95	Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim…	- Use modifier 95 to indicate a service was furnished via synchronous, real‑time audiovisual telehealth (a live audio‑video conference between patient and provider) rather than in‑person. - Pair…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
372500000X	Chore Provider	An individual who provides home maintenance services required to sustain a safe, sanitary living environment for individuals who because of age or dis…
363L00000X	Nurse Practitioner	(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
207Q00000X	Family Medicine Physician	Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
207R00000X	Internal Medicine Physician	A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
202C00000X	Independent Medical Examiner Physician	A special evaluator not involved with the medical care of the individual examinee that impartially evaluates the care being provided by other practiti…
2083T0002X	Medical Toxicology (Preventive Medicine) Physician	Medical toxicologists are physicians who specialize in the prevention, evaluation, treatment and monitoring of injury and illness from exposures to dr…
152WS0006X	Sports Vision Optometrist	An optometrist who offers services designed to care for unique vision care needs of athletes, which may include one of more of the following services:…
207LH0002X	Hospice and Palliative Medicine (Anesthesiology) Physician	An anesthesiologist with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This …

HCPCS G9490: Home Visit Patient Assessment for Non-Homebound Beneficiary

HCPCS-G0008-INFLUENZA-VACCINE-ADMINISTRATION

HCPCS G0008: Administration of Influenza Virus Vaccine

HCPCS-G0009-PNEUMOCOCCAL-VACCINE-ADMINISTRATION

HCPCS G0009: Administration of Pneumococcal Vaccine

HCPCS-G0010-HEPATITIS-B-VACCINE-ADMINISTRATION

HCPCS G0010: Administration of Hepatitis B Vaccine

HCPCS-G0011-PREP-COUNSELING-HIV-RISK-REDUCTION-ADHERENCE

HCPCS G0011: Individual PrEP Counseling, HIV Risk Assessment

HCPCS-G0012-PRE-EXPOSURE-PROPHYLAXIS-INJECTION-HIV-PREVENTION

HCPCS G0012: Injection of PrEP Drug for HIV Prevention

HCPCS-G0013-PREP-INDIVIDUAL-COUNSELING-HIV-RISK-REDUCTION

HCPCS G0013: Individual PrEP Counseling by Clinical Staff

HCPCS-G0017-PSYCHOTHERAPY-CRISIS-FIRST-60-MINUTES-NON-OFFICE

HCPCS G0017: Psychotherapy for Crisis, First 60 Minutes

HCPCS-G0018-PSYCHOTHERAPY-CRISIS-ADDITIONAL-30-MINUTES-NON-OFFICE

HCPCS G0018: Psychotherapy for Crisis, Additional 30 Minutes

HCPCS-G0019-COMMUNITY-HEALTH-INTEGRATION-SDOH-CARE-COORDINATION

HCPCS G0019: Community Health Integration, Person-Centered Assessment

Showing 1–10 of 1996

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Workflow:

The beneficiary is referred by a primary care clinician or self-enrolls with an MDPP supplier.
During the intake visit, the supplier documents eligibility, baseline measurements, and obtains informed consent for program participation.
The supplier delivers CDC-approved DPP curriculum content in scheduled one-hour core sessions (weeks 1–9+), recording attendance for each session.
After the ninth session, the supplier records the attendance event and bills G9875 to Medicare under the MDPP Expanded Model. Attendance records and supporting documentation (session date, duration ~1 hour, curriculum adherence, and beneficiary identity) are retained for audit and quality reporting.
Ongoing data collection continues for behavior change metrics (weight loss, physical activity) and continued sessions beyond month 6 as applicable.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99406`	Smoking and tobacco use cessation counseling visit, intermediate, greater than 3 minutes up to 10 minutes	May be provided in primary care visits preceding or concurrent with MDPP enrollment for behavioral risk counseling.

| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | May be used by clinicians for weight management counseling that complements MDPP sessions.

| 96127 | Brief emotional/behavioral assessment (e.g., PHQ-2, PHQ-9) | Used to screen for depression or behavioral barriers before or during MDPP participation.

Related Modifiers

5 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
95	Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim…	- Use modifier 95 to indicate a service was furnished via synchronous, real‑time audiovisual telehealth (a live audio‑video conference between patient and provider) rather than in‑person. - Pair…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
372500000X	Chore Provider	An individual who provides home maintenance services required to sustain a safe, sanitary living environment for individuals who because of age or dis…
363L00000X	Nurse Practitioner	(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
207Q00000X	Family Medicine Physician	Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
207R00000X	Internal Medicine Physician	A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
202C00000X	Independent Medical Examiner Physician	A special evaluator not involved with the medical care of the individual examinee that impartially evaluates the care being provided by other practiti…
2083T0002X	Medical Toxicology (Preventive Medicine) Physician	Medical toxicologists are physicians who specialize in the prevention, evaluation, treatment and monitoring of injury and illness from exposures to dr…
152WS0006X	Sports Vision Optometrist	An optometrist who offers services designed to care for unique vision care needs of athletes, which may include one of more of the following services:…
207LH0002X	Hospice and Palliative Medicine (Anesthesiology) Physician	An anesthesiologist with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This …

HCPCS G9490: Home Visit Patient Assessment for Non-Homebound Beneficiary

HCPCS-G0008-INFLUENZA-VACCINE-ADMINISTRATION

HCPCS G0008: Administration of Influenza Virus Vaccine

HCPCS-G0009-PNEUMOCOCCAL-VACCINE-ADMINISTRATION

HCPCS G0009: Administration of Pneumococcal Vaccine

HCPCS-G0010-HEPATITIS-B-VACCINE-ADMINISTRATION

HCPCS G0010: Administration of Hepatitis B Vaccine

HCPCS-G0011-PREP-COUNSELING-HIV-RISK-REDUCTION-ADHERENCE

HCPCS G0011: Individual PrEP Counseling, HIV Risk Assessment

HCPCS-G0012-PRE-EXPOSURE-PROPHYLAXIS-INJECTION-HIV-PREVENTION

HCPCS G0012: Injection of PrEP Drug for HIV Prevention

HCPCS-G0013-PREP-INDIVIDUAL-COUNSELING-HIV-RISK-REDUCTION

HCPCS G0013: Individual PrEP Counseling by Clinical Staff

HCPCS-G0017-PSYCHOTHERAPY-CRISIS-FIRST-60-MINUTES-NON-OFFICE

HCPCS G0017: Psychotherapy for Crisis, First 60 Minutes

HCPCS-G0018-PSYCHOTHERAPY-CRISIS-ADDITIONAL-30-MINUTES-NON-OFFICE

HCPCS G0018: Psychotherapy for Crisis, Additional 30 Minutes

HCPCS-G0019-COMMUNITY-HEALTH-INTEGRATION-SDOH-CARE-COORDINATION

HCPCS G0019: Community Health Integration, Person-Centered Assessment

Showing 1–10 of 1996

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

HCPCS G9875: MDPP Nine Core Sessions (Expanded Model)

Sign up for hcpcs G9875 policy alerts

OpenPayer

HCPCS G9875: MDPP Nine Core Sessions (Expanded Model)

Sign up for hcpcs G9875 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

References

HCPCS G9875: MDPP Nine Core Sessions (Expanded Model)

Sign up for hcpcs G9875 policy alerts

HCPCS G9875: MDPP Nine Core Sessions (Expanded Model)

Sign up for hcpcs G9875 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What does HCPCS code G9875 represent?

Where and how are the MDPP core sessions tied to G9875 typically delivered?

Which modifiers should be considered when billing G9875?

Are there other codes commonly billed alongside G9875?

What ICD-10 diagnoses are relevant when billing G9875?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What does HCPCS code G9875 represent?

Where and how are the MDPP core sessions tied to G9875 typically delivered?

Which modifiers should be considered when billing G9875?

Are there other codes commonly billed alongside G9875?

What ICD-10 diagnoses are relevant when billing G9875?

References