If you are a provider that accepts Aetna Commercial and Medicare Plans? Then this blog post is for you!
For any DOS 9/1/2026 and thereafter Aetna, once the provider bills the modifier CT, will apply a 15% payment reduction will be applied to certain radiology services.
Definition: CT modifier is used to represent that CT (computed tomography) technology used does not meet the National Electrical Manufacturers Association (NEMA) XR 29-2013 “Smart Dose”
standards.
The reduction will apply to the following:
The technical component (TC) of the service
- The TC portion of global billing
- Computed tomography (CT) imaging services
- Both the Medicare Physician Fee Schedule (MPFS) and the Outpatient Prospective
Payment System (OPPS
Find this information useful? Follow my blog for more.
Need a reference guide that brings up to date medical coding, billing and reimbursement information? Visit my reference guides page!
- UHC: The Michigan Collaborative for Type 2 Diabetes (MCT2D)- changes
- NYS Medicaid: Billing for denture services (FQHCs) patients with third party insurance
- Fidelis: corrected claim submissions
- BCBS Highmark NY:
- NYS OMH ACT services- new rate codes for 2027

Leave a Reply