According to Aetna June 2022 provider newsletter- Aetna will NO Longer pay for the mid level staff: nurse practitioners, physician assistants, certified nurse midwives and clinical nurse specialists, at 100%, if they are performing the following codes:
Long description: Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment
Short description: Initial preventive exam
G0438- Long description: Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit
Short description: Ppps, initial visit
G0439- Long description: Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
Short description: Ppps, subseq visit
Note to Washington State providers: Your effective date for changes described in this article will be communicated following regulatory review.
How can you access the full policy?
Log in to Availity*** and follow these steps:
- Click on Payer Spaces > Aetna.
- In the search box, type “mid-level practitioners” and click Search.
- Choose “Mid-level Practitioners and Other Qualified Health Care Professionals — Resource.”
This policy applies to Aetna commercial and Medicare members.
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