Aetna Commercial and Medicare Plans: Payment for Occupational Therapy/Physical Therapy Assistants

As per Aetna Updates: starting December 1,2023 the Occupational Therapy Assistants and Physical Therapy Assistants will get their own reimbursement for performed services.

Reimbursement amount: 85% of Allowed amount.

Please append the following modifiers to the services that are performed by the PTAs and OTAs:

CO-occupational therapy services performed in part or as a whole by an Occupational Therapy Assistant

CQ-physical therapy services performed in part or as a whole by a Physical Therapy Assistant.

This change applies to Medicare and Commercial plan types.

Find this type of content useful? Follow my blog for more medical billing and coding updates/changes from various insurance payers.

Previous Blog Posts:

NYS Medicaid: Article-29 VFCA medical billing changes

Are you an Article -29 VFCA facility or a provider that performs the services at such facility? Then the following blog post is for you! As of Nov 20, 2025 NYS DOH updated the Article-29 VFCA billing and coding guide. Notable Changes: Where to find all of the info? Find this information useful? Follow my…

NY State PDN services updates: new forms

If you are a an independent RN/LPN or work for an agency and provide PDN services to the members that have PDN benefit available, then this blog post is for you! As per NYS Medicaid- starting for DOS 7/1/26 and thereafter there 2 new forms that will be required in addition to other needed documentation.…

Leave a comment