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  • Telehealth 2025: The Final Rule - AAPC Knowledge Center
    Medicare reinstates certain pre-pandemic telehealth policies COVID-19 public health emergency waivers that applied to Medicare Part B policies for The 2025 PFS final rule is the final word for telehealth services effective Jan 1, 2025, unless Congress acts
  • Aetna E M Policy | Medical Billing and Coding Forum - AAPC
    Now, I couldn't find Aetna's E M policy, but I would be very surprised if they decided to deviate too much on that sense Possible reasons for the denial:-The patient was seen by the same provider at a previous practice, within 3 years-The patient was seen by a similar credentialed provider from the same practice (fairly common denial reason)
  • Telehealth Services After the PHE - AAPC Knowledge Center
    Just an FYI to the article from the author: The use of the -93 modifier is currently active, but optional CMS has stated that the -95 modifier is for Telehealth services through 2024, due to payment parity
  • Billing Medicare for Telehealth Services in 2024 - AAPC
    Through Dec 31, 2024, there are no geographic restrictions for patients or providers For Medicare, use the place of service code that identifies where the patient is located: POS 02 when the patient is not at home or POS 10 if the telehealth is provided in the patient’s home
  • Wiki - 76830 and 76856 | Medical Billing and Coding Forum - AAPC
    per Encoder these 2 codes are not bundled The report combines the findings into one but is clearly two approaches The insurance I am having an issue with is Aetna They are inconsistent however always bundle one into the other and only pay for one-sometimes the transvag and sometimes the pelvic ultrasound
  • CPT® Code 64454 - AAPC
    CPT Code 64454, Introduction Injection of Anesthetic Agent (Nerve Block), Diagnostic or Therapeutic Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System, Introduction Injection of Anesthetic Agent (Nerve Block), Diagnostic or Therapeutic Procedures on the Somatic Nerves - Codify by AAPC
  • Telehealth: Medicare Policy for CY 2025 - AAPC
    Rulemaking and lawmaking keep telemedicine a viable solution for the masses, for now Now that the dust has settled on the American Relief Act, 2025, Medicare policy for telehealth services is extended through March 31, but then what?
  • Wiki CPT 81003 inclusvie denieal from Aetna. - AAPC
    Aetna insurance frequently denying CPT 81003 or 81002 charges as inclusive with E M service (99201-99395) Initially I tried with modifier “25” to E M, after that I even tried with an appeal, but no use, it denied as inclusive again In this case I need clarification that, is there any payer policy in Aetna website regarding this
  • Wiki Telehealth visits and modifier for 2025 - AAPC
    Aetna - Follow Medicare (per their risk adjustment inquiry team– no updated policy of their own yet) BCBS - Follow Medicare (may want to check on this later to see if they update) Cigna - Yes to new codes (per rep) Policy will update at end of Jan (may want to wait until then to use the new codes)
  • Bill G2211 With Confidence (and Modifier 25) - AAPC
    I have a claim where we billed for E M 99214, 99397, G0439, G0444, and G2211 G2211 has denied due to bundled and service not payable with other service rendered on the same date





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