You are now being directed to CVS Caremark site. This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. Request an Office Transfer. Copyright 2015 by the American Society of Addiction Medicine. Some subtypes have five tiers of coverage. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. Explore our savings, quality care and wellness solutions to craft the perfect plan for your business. If services are not covered by the Medicare plan, Aetna Better Health of Ohio may cover these services. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. However, applicable state mandates will take precedence with respect to fully insured plans and self-funded non-ERISA (e.g., government, school boards, church) plans. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. The term precertification here means the utilization review process to determine whether the requested service, procedure, prescription drug or medical device meets the company's clinical criteria for coverage. Aetna's conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna). Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). Any use of CPT outside of Aetna Clinical Policy Bulletins (CPBs) should refer to the most current Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. Guardian is a registered trademark of The Guardian Life Insurance Company of America, New York, NY. This list is updated nightly. No fee schedules, basic unit, relative values or related listings are included in CPT. License to use CPT for any use not authorized herein must be obtained through the American Medical Association, CPT Intellectual Property Services, 515 N. State Street, Chicago, Illinois 60610. Choose the type of plan you're interested in to search for health care providers that accept it. Aetna makes no representations and accepts no liability with respect to the content of any external information cited or relied upon in the Clinical Policy Bulletins (CPBs). Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Prior Authorization may be required. Exploration our provider manuals for find resources concerning Aetna policy guidelines that explain how to work with us. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Aetna Inc. and itsaffiliated companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites. Please correct the following errors and try again: Fill out this form to find providers and health care facilities near you. When billing, you must use the most appropriate code as of the effective date of the submission. Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Since Clinical Policy Bulletins (CPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies. It is only a partial, general description of plan or program benefits and does not constitute a contract. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Links to various non-Aetna sites are provided for your convenience only. The path to healthy starts here. This Agreement will terminate upon notice if you violate its terms. You are now being directed to CVS Caremark site. Plan from an employer Aetna Medicare plan, Individual health plan Aetna Medicaid plan CPT only Copyright 2022 American Medical Association. The five character codes included in the Aetna Clinical Policy Bulletins (CPBs) are obtained from Current Procedural Terminology (CPT), copyright 2015 by the American Medical Association (AMA). Directory of Dentists Treating Members with Intellectual Disabilities Adult. The member's benefit plan determines coverage. Street Address: . Let Customer Service know the providers you called. A new version of our find a dentist tool is now available for Virginia members! Disclaimer of Warranties and Liabilities. We work with physicians to develop common platforms and goals, shifting the focus from episodes of care to making patient populations healthier. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Precertification Code Search Tool. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. Treating providers are solely responsible for medical advice and treatment of members. Dental Provider Login | Aetna All Rights Reserved. Just call Member Services at 1-866-329-4701 (TTY: 711) to learn more about these services. CMS requires providers to take the Model of Care training course (PDF). Primary Care Providers, specialists, mental health providers, Qualified Family Planning Providers (QFFPs), dentists and vision care providers. New and revised codes are added to the CPBs as they are updated. Working with providers, our advanced care management techniques help increase quality, improve efficiency . The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Please log in to your secure account to get what you need. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. NJ FIDE-SNP members will have one member ID card for both Medicare and Medicaid. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. We're sorry but Provider Locator doesn't work properly without JavaScript enabled. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Visit the secure website, available through www.aetna.com, for more information. Links to various non-Aetna sites are provided for your convenience only. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. The responsibility for the content of Aetna Clinical Policy Bulletins (CPBs) is with Aetna and no endorsement by the AMA is intended or should be implied. Search By NPI or PIN : DocFind - aetna.com Depending on the members MSP eligibility, they may have a cost-share responsibility. It is only a partial, general description of plan or program benefits and does not constitute a contract. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. Click here to find an in-network vision provider thats close to you. Since there is no paperwork or reimbursement, you must pay for the service at the time its provided. By providing us with your email address, you agree to receive email communications from Aetna until you opt out of further emails. list of CPT or HCPCS codes to only those requiring PA, please check the box labelled Include only CPT or HCPCS codes where PA is required?. Address, phone number, and practice changes. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. Contact Us - Health Care Providers - Aetna Enter a zip code to search for dental care professionals in your area. Avsis provides vision and dental claim and administrative services by agreement with Aetna Inc. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. All Rights Reserved. You are now being directed to the CVS Health site. If you are looking for a specific provider and cannot find them online, need more information,help, or would like a printed copy of the provider directory mailed to you,callus at 1-855-242-0802, TTY 711, 24 hours a day, 7 days a week. If you are in Virginia, check your status by going to the Aetna Better Health of Virginia provider search page. Pharmacy prior auth phone number: 1-855-221-5656. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Learn about your health plan or find coverage for you and your family. PA requirements are both Yes and No, as specified on the PA List. Links to various Aetna Better Health and non-Aetna Better Health sites are provided for your convenience. #2020-93661 (exp. Medicaid. Unlisted, unspecified and nonspecific codes should be avoided. Idaho Members: If you contact several providers who have indicated they will see new patients and find you cannot get an appointment, you may call Customer Service at 1-800-936-0978. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. Please log in to your secure account to get what you need. Please confirm with the provider when you call them. AetnaDentalOffers.com is brought to you by DentalPlans.com. Aetna Inc. and its affiliated companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. A new version of our find a dentist tool is now available for Illinois members! Pediatric Dentists: provide dental care for children and young adults. Choose from the largest directory of in-person & video visit providers in the nation. In addition, a member may have an opportunity for an independent external review of coverage denials based on medical necessity or regarding the experimental and investigational status when the service or supply in question for which the member is financially responsible is $500 or greater. Need a new dental office home? Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. This information is neither an offer of coverage nor medical advice. This Aetna provider directory includes all Aetna participating providers, including both medical providers and dental providers. Just enter your mobile number and well text you a link to download the Aetna Health app from the App Store or on Google Play. Need a new dental office home? You can get a copy of the provider directory by mail. If you have any questions about authorization requirements or need help with the search tool, contact Aetna Better Health Provider Relations at 1-855-364-0974. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. CPT only copyright 2015 American Medical Association. New and revised codes are added to the CPBs as they are updated. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Some subtypes have five tiers of coverage. The responsibility for the content of Aetna Clinical Policy Bulletins (CPBs) is with Aetna and no endorsement by the AMA is intended or should be implied. This search will use the five-tier subtype. Check your participation status using the provider search tool. Copyright 2015 by the American Society of Addiction Medicine. This information helps us provide information tailored to your Medicare eligibility, which is based on age. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. We update our provider directory nightly.You can get a copy of the provider directory by mail. Adult day services, assisted living, home-delivered meals, home health agencies and home medical equipment providers. CPT only copyright 2015 American Medical Association. up to six Current Procedural Terminology (CPT) or Healthcare Common Procedure Coding The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this product. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. All rights reserved. Learn about Aetna Smart Compare. Hospitals, long-term care facilities and skilled nursing facilities for rehabilitation, mental health facilities, Federally Qualified Health Centers and Rural Health Centers. Aetna Better Health - LIBERTY Dental Plan Click here to find an in-network pharmacy provider thats close to you. Find a Dentist. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Provider Search is provided solely for the personal, non-commercial use of current and prospective Aetna members and providers. Aetna makes no representations and accepts no liability with respect to the content of any external information cited or relied upon in the Clinical Policy Bulletins (CPBs). Dentists and dental office professionals, log in to Aetna Dental to handle claims, find forms, stay ahead of policy changes and more. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. VisitPharmacy Provider Search to view all your pharmacy providers. Click here to find an in-network dental provider thats close to you. Directory of Dentists Treating Members with Intellectual . Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Best viewed in Microsoft Internet Explorer 6 and higher, resolution 1280x800. License to use CPT for any use not authorized herein must be obtained through the American Medical Association, CPT Intellectual Property Services, 515 N. State Street, Chicago, Illinois 60610. Others have four tiers, three tiers or two tiers. Aetna Provider Search - Small Business Benefits | Trustmark