`G9001` Mccd, initial rate

Coordinated care fee, initial rate

Medicare coverage: Special coverage instructions apply
Status: active (October 2026 file)

Medicare pricing for G9001

Physician Fee Schedule (CY 2026, RVU26D)

Status X: statutory exclusion, not paid under the PFS.

Payer policies and prior authorization for G9001

1 of 1 payer prior-auth lists that name G9001 require prior authorization or set conditions: Molina Healthcare of Idaho.

Payer	Plan	State	Prior auth	Conditions	Since	Source
Molina Healthcare of Idaho	Medicaid	ID	prior auth required	State exception; Codes are covered for LTSS plans only	Jan 1, 2025	Idaho Medicaid Prior Auth (PA) Code Matrix and Idaho code/benefit exceptions, Q1 2025

Payer coverage policies that name G9001

G9001 appears in 1 coverage policy from Blue Shield of California.

Payer	Policy	Role in policy	Reviewed	Document
Blue Shield of California	BSC2.11 \| Diabetes Prevention Program	listed, no stance		payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

ND: $0.00 (physician), effective Aug 1, 2026
VA: $25.00 (medical), effective Jun 20, 2003
VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.

G9001 Mccd, initial rate