An Aetna Medicare Advantage (MA) patient is coming for outpatient therapy services. You want to provide a service that the MA plan does not cover. You inform the patient of their financial responsibility. The patient agrees to pay you this fee for the noncovered service(s). You think you have done this process correctly. But wait, maybe you have not done it correctly. Contracted providers can’t bill Aetna MA patients for a service not covered under their planunless the provider or the patient obtain

If you have read one commercial insurer’s therapy policies, you have read one commercial insurer’s therapy policies. That is why I have created an extensive frequently asked questions (FAQs) page dedicated to Aetna and outpatient therapy. This Aetna FAQ page will provide you answers to some of the most common questions I receive regarding Aetna and outpatient therapy services. Questions answered include, but are not limited to: To read the answers to the above questions, click HERE.

Aetna has revised their Physical Therapy Clinical Policy Bulletin. Revisions include the following:

Aetna Medicare Advantage plans may not cover all the outpatient therapy services your patient requires. For the services that they do not cover, does this mean you can charge the patient cash? In this article, I will provide you answers to the following questions:

Aetna has announced 2 major changes that have a significant impact on outpatient physical therapy services. In this article, I will answer the following questions:

A question I am often asked is do all Medicare Advantage (MA) plans follow traditional Medicare’s “8-minute rule”. The answer depends on the MA plan. Regarding Aetna MA and do they follow Medicare’s “8-minute rule”, the answer is

Aetna has announced they will implement a payment reduction when outpatient therapy services are provided in whole or in part by a physical therapist assistant or an occupational therapy assistant. In this article, I will provide answers to the following questions:

Aetna has revised the effective date of their implementation to reduce payment when outpatient therapy services are provided in whole or in part by a physical therapist assistant or an occupational therapy assistant. Click HERE to read the updated article with the new effective date.