New Conversion Factor Update with Changes to Physician Payments
April 4, 2024External Cephalic Version-01958
May 6, 2024Aetna Aligns Policies with Medicare Guidelines
Aetna announced an anesthesia reimbursement shift on January 1, 2024. Aetna announced all Medicare Advantage plans managed by Aetna would no longer reimburse for physical status modifiers beginning April 1, 2024. The information was quietly received as this aligns with the majority of Medicare plans.
As the implementation for the Advantage plan took effect, on April 8, 2024, there was a release that Aetna’s commercial plans will also stop reimbursing additional unit value(s) for anesthesia physical status modifiers starting July 15, 2024.
The decision aims to align with Medicare guidelines. While it applies nationwide, different effective dates or considerations may apply to Washington State and Texas, subject to regulatory review and requirements.
This policy change includes a 90-day advance notice and may pose challenges for anesthesia providers seeking reimbursement. Providers can contact their account executives for further clarification.
Click here to read the Aetna policy.
BCBS Begins Anesthesia Reimbursement Shift
Not to be outdone, BCBS in certain states such as Texas, Oklahoma, Illinois, and Montana has released similar information for policy: CPCP010 to be in effect June 1, 2024.
Click here to read the Texas Policy.
Click here to read the Oklahoma Policy.
Click here to read the Illinois Policy.
Click here to read the Montana Policy.
If you have questions or would like a focused audit on how this could financially impact your group please contact us.