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.
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Past Blog Posts:
MVP (NY/VT)- Reimbursement sick visit and Preventative Care on the same day.
Effective 5/1/23 MVP insurance payer will start to reimburse 50% for the E&M code that represents the sick visit and is billed on the same day as the preventative E&M code. The providers should expect this reduction to apply to the code even if the modifier 25 is appended on the sick E&M code. This…
MVP Health Plans: reimbursement of sick E&M codes billed w/preventative codes -05/01/23
According to the latest announcement MVP Health Plan will change the reimbursement of sick E/M codes when they are billed on the same day as a preventative codes. This policy applies to Primary Care Physicians. According to the new reimbursement policy the sick E&M codes will be reimbursed at 50% of allowable amount if the…
Michigan Medicaid: reimburses for Doula Services-01/01/23
The new coverage policy applies to Medicaid, Healthy Michigan Plan, MI Health Link, MIChild, MaternityOutpatient Medical Services Programs. Effective 01/01/23 – Michigan Medicaid members that belong to the above mentioned programs will be able to receive services from a certified doula during the the prenatal, labor and delivery, and postpartumperiods. Doula- non clinical professional that…
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