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News from Aetna: The insurer recently clarified that its November 2023 decision to end payment for communications-based technology codes and some telehealth services applies only to its employer-based plans. Commercial plans will continue to pay for those codes and services.

Specifically, for employer-based plans only, Aetna no longer covers E-Visits (CPT codes 98970-98972), Remote Evaluation of Patient Videos/Images (HCPCS code G2250), Virtual Check-Ins (HCPCS codes G2251 and G2252), or Telephone Assessment and Management (CPT codes 98966-98968), collectively known as communication-based technology services. Additionally, the insurer ended coverage for some services when delivered via telehealth. Among the codes for these services are some that may be billed by PTs: 90901, 97129, 97130, 97150, 97163, 97164, 97542, and 97763. Aetna also no longer covers CPT code 97535 as an audio-only code. The changes to employer-based plans took effect on Dec. 1, 2023.

Employer-based plans continue to include payment to PTs for some services when delivered via telehealth and submitted with the appropriate modifier (GT or 95). This continuation applies to codes 97750, 97110, 97112, 97116, 97161, 97162, 97530, 97537, 97755, 97760, and 97761.


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