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    OpenPayerBilling CodesProcedures / Professional ServicesHCPCS hcpcs-g9890-mdpp-bridge-payment-first-session-transition
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    HCPCS G9890: MDPP Bridge Payment for First Transition Session

    HCPCS Level II code G9890 designates a one-time bridge payment for the first Medicare Diabetes Prevention Program (MDPP) core, core maintenance, or ongoing maintenance session furnished by an MDPP supplier to an MDPP beneficiary during months 1–24 of the MDPP Expanded Model who previously received MDPP services from a different MDPP supplier; service type is a transitional MDPP session payment and the typical site of service is the MDPP supplier’s program setting where group or individual MDPP sessions are delivered.

    For related coverage guidance, see recent payer policy updates: Esophagogastroduodenoscopy (EGD) Coverage Policy, Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD), Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver Disease.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old Medicare beneficiary previously enrolled in the Medicare Diabetes Prevention Program (MDPP) Expanded Model (EM) with Supplier A transfers care to Supplier B at month 10. The beneficiary has completed some MDPP sessions with Supplier A and now attends a first MDPP core session with Supplier B. Supplier B bills a one-time bridge payment for the first MDPP session furnished to a beneficiary who previously received MDPP services from a different MDPP supplier during months 1–24 of the MDPP EM.

    A typical clinical workflow: the beneficiary contacts the new MDPP supplier, completes intake and eligibility verification, and the supplier documents prior MDPP participation with Supplier A. The supplier furnishes the appropriate MDPP core, core maintenance, or ongoing maintenance session and documents the session date, content, and evidence of prior supplier participation. The supplier submits claim for the one-time bridge payment using HCPCS code G9890, including any applicable modifier(s) to indicate circumstances such as unusual procedural service or billing scenario, and retains documentation showing the beneficiary previously received MDPP services from a different MDPP EM supplier. The supplier may receive only one G9890 payment per beneficiary.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99401Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual; approximately 15 minutesMay be used when individual preventive counseling sessions are billed to payors alongside MDPP services in commercial plans; not a Medicare MDPP payment code but relevant to associated counseling workflows.
    99406Smoking and tobacco-use cessation counseling visit, intermediate, greater than 3 minutes up to 10 minutesOccasionally billed by providers addressing tobacco use as part of comprehensive lifestyle counseling associated with diabetes prevention efforts; adjunctive to MDPP sessions.
    97802Medical nutrition therapy; initial assessment and intervention, individual, face-to-face, 15 minutesUsed when a registered dietitian provides medical nutrition therapy that may overlap with MDPP nutrition components; may be billed separately when payor policy allows.
    G0447Face-to-face behavioral counseling for obesity, 15 minutesBehavioral counseling for weight loss delivered in primary care; clinically related to MDPP goals and may be billed by some suppliers in related workflows.
    99412Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual; approximately 30 minutesUsed for longer individual preventive counseling sessions that align with MDPP content when billing payors that accept these CPT codes in conjunction with MDPP activities.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    22Modifier –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…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑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…
    53Modifier 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…
    54Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    62Modifier 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…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    170100000XPh.D. Medical GeneticsA medical geneticist works in association with a medical specialist, is affiliated with a clinical genetics program, and serves as a consultant to med…
    163W00000XRegistered Nurse(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive…
    367A00000XAdvanced Practice MidwifeAdvanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproduc…
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    111NI0013XIndependent Medical Examiner ChiropractorA special evaluator not involved with the medical care of the individual examinee that impartially evaluates the care being provided by other practiti…
    207PP0204XPediatric Emergency Medicine (Emergency Medicine) PhysicianPediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency de…
    3416S0300XWater AmbulanceTransportation Services · Ambulance
    374700000XTechnician(1) A person with specialized training in a narrow field of expertise whose occupation requires training and is skilled in specific technical processe…

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    E11.21Type 2 diabetes mellitus with diabetic nephropathy
    E11.29Type 2 diabetes mellitus with other diabetic kidney complication
    E11.42Type 2 diabetes mellitus with diabetic polyneuropathy
    E11.65Type 2 diabetes mellitus with hyperglycemia
    E11.8Type 2 diabetes mellitus with unspecified complications
    E11.9Type 2 diabetes mellitus without complications
    E66.01Morbid (severe) obesity due to excess calories
    E66.3Overweight
    E66.9Obesity, unspecified
    E78.2Mixed hyperlipidemia

    Showing 1–10 of 25

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 3

    10 rows

    PolicyPayerEffective Date
    Esophagogastroduodenoscopy (EGD) Coverage Policyevicore2026-11-05
    Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD)univerahealthcare2026-10-15
    Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver DiseaseOscar Health2026-10-01
    Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant TestingOscar Health2026-10-01
    Pancreatic Enzyme Testing for Acute PancreatitisOscar Health2026-10-01
    Helicobacter pylori TestingOscar Health2026-10-01
    Celiac Disease TestingOscar Health2026-10-01
    Laboratory Testing for the Diagnosis of Inflammatory Bowel DiseaseOscar Health2026-10-01
    Percutaneous Electrical Nerve Field Stimulation (PENFS)Cigna2026-09-15
    Colorectal Cancer ScreeningBlue Cross Blue Shield - New Mexico2026-09-04

    Related Codes

    HCPCS-G9490-HOME-ASSESSMENT-NON-HOMEBOUND

    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

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    Frequently Asked Questions

    References

    1. 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. 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. 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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