Do you or your office reports social determinants and accept Aetna Better Health members? Great news! Now according to an update sent to the physicians, the insurance plan will reimburse for certain Z codes that correspond to certain social determinants of health.
Some of these Social Determinants of Health include (not all included):
• Assistance reapplying for Medicaid benefits
• Transportation: ModivCare
• Cleaning: Pest control, carpet cleaning, house cleaning
• Housing Specialist: assist with housing searches, voucher applications, transitioning from institution to
community
• Member Advocates: assist with coordinating and access to community resources
• In-office care management support for provider or specialist visits
• Peer support specialist
• Disease management education
• Smoking cessation support services
The Z codes will be reimbursed when they are billed with code: G9919
Partial list of covered Z codes:

For full list of the covered Z codes that are covered, please click here.
Find this type of content useful, then follow my blog. Get your updated information about medical coding and billing guidelines, reimbursement/medical policies, prior authorization changes, etc.
Past Blog Posts:
Healthfirst: crutches and cane reimbursement
Are you a provider that bills for crutches or canes then this blog post is for you! For single item: Effective DOS 10/1/25 and thereafter the providers will only reimburse 1 cane or a crutch per patient/per day. Unless there is prior authorization with a justification given in advance. For multiple crutches: No multiple crutches…
UHC Community Health of MA: 2 DSNP 2 plans important coverage update.
Are you a provider from MA that accepts UHC plan types mentioned below and is having issues with reimbursement? It could be due to a recent MA Medicaid (MassHealth) change to the eligibility for DSNP plan members. Plans affected: UHC Community Health plan ls of Massachusets-DSNP plans: Due to a termination of MA Medicaid (MassHealth)…
NYS RX: adult vaccine reimbursement and Billing change
There is an update to how the NYS Medicaid Pharmacy program will reimburse the pharmacies for vaccines that are billed by the NDC#. This change does not apply to the vaccines administered under Vaccines for children program. Proper Billing: for any vaccines that are billed by the NDC One claim should be submitted with a…
pre

Leave a comment