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:
EmblemHealth Commercial Plan: new facility transfer policy
This new policy applies to transfer of patient from one acute facility to another one for the same related care. What is new? For the complete new reimbursement policy, click here. Find this type of content useful? Follow my blog for more!
UHC: Gold Program- list updated- 4/1/26
If you are a provider that participates in UHC Gold Program, then this blog post is for you! What is the update? Affected Plans: Updated list, effective 4/1/26: For the complete list, please click here. Find this information useful? Follow my blog for more!
Cigna Commercial Plans: IVR system update
If you are a provider that accepts Cigna commercial plans and uses IVR to check member benefits, eligibility etc., then this blog post is for you! According to Cigna- in order to reduce wait times, ensure that the representatives are available for legitimate calls, and ensure that the patient information is protected there will be…
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KR2 Medical Billing 
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