Aetna Better Health® of Ohio continues to review current medical reimbursement policies when appropriate. Part of the process includes an assessment of the current default percentage reimbursed when a code is not priced on the Aetna Market Fee Schedule, which is based on Medicare and Medicaid rates.
Effective on or after 10/01/18, codes not priced on the Aetna Market Fee Schedule will reimburse at 20% of billed charges. This will allow our provider network time to adjust and make changes as needed.
If you have further questions about this change in our standard default reimbursement for codes without an identified rate on the fee schedule please reach out to us by email at OH_ProviderServices@aetna.com or by phone at 1-855-364-0974.