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02/26/24

Aetna Implements Assistant Payment Reduction

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:

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10/30/23

Aetna Updates Implementation of Assistant Payment Reduction

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.

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09/18/23

Aetna to Implement Assistant Payment Reduction

Article Updated on October 26, 2023 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:

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05/03/21

Can Therapists Utilize Aides/Techs with Aetna Patients?

QuestionDoes Aetna allow a physical therapist (PT) to utilize a rehab aide/tech to provide delegated patient-related tasks to an Aetna beneficiary receiving outpatient physical therapy services under their direct supervision and bill for those services to Aetna? Answer I hope you found this article helpful to your practice or organization. Thank you for being a Gold Member!

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02/22/21

NCCI Edit Changes for Aetna, Cigna and Humana

Aetna, Cigna and Humana have all announced changes to their respective policies related to the National Correct Coding Initiative (NCCI) procedure-to-procedure (PTP) edits and the payment of a CPT code(s) that has had modifier 59 appended to it on the claim form. These positive changes would not have occurred without the advocacy of the American Physical Therapy Association (APTA). Aetna Aetna has informed Cigna According to Humana Humana has informed I hope you found this article and information helpful. Thank you for being a Gold Member!

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01/04/21

Aetna Telehealth Update: January 2021

Aetna has announced they have extended their coverage of telehealth services for physical, occupational and speech therapy for their Commercial and Medicare Advantage plans. The extended coverage end date is I hope you found this information helpful. Thank you for being a Gold Member!

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09/01/20

Aetna to Reactivate Billing Modifiers 25, 59 and X series

Aetna has announced they will reactivate edits when a CPT code on the claim form contains billing modifiers 25, 59 or X series (XE, XP, XS, XU). This reactivation will apply to the states of I hope you found this article helpful. Thank you for being a Gold Member!

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07/27/20

July 2020 Telehealth Updates

With the Secretary of the Department of Health and Human Services extending the Public Health Emergency (PHE) due to the COVID-19 pandemic, many private practices as well as facilities and organizations want to know what does this mean for the extension of providing outpatient therapy services via telehealth. In this article, I will provide updates on outpatient therapy services delivered via telehealth for the traditional Medicare Part B program and some of the larger national insurance carriers. Medicare (Traditional) Aetna Anthem BCBS of Colorado Anthem BCBS of Connecticut Anthem BCBS of Georgia Anthem BCBS of Indiana Anthem BCBS of Kentucky

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