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!
- Aetna: usage of modifier CT and reimbursement
- NYS Medicaid: Article-29 VFCA medical billing changes
- SOMOS IPA and EmblemHealth to term relationship
- NY State PDN services updates: new forms
- Healthfirst Genertic testing- updated reimbursement policies
KR2 Medical Billing 
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