Telemedicine | Aetna (2024)

FAQs

What is the telemedicine modifier for Aetna? ›

Modifiers GT, 95, FR

When a provider reports modifier GT or 95, it certifies the patient received services via an audiovisual telecommunications system. Click herefor more information about our telemedicine liberalization in response to the Coronavirus COVID-19 outbreak.

Aetna already has a proud history serving the health care needs of New Jersey's state employees and their dependents — our Medicare Advantage program provides health care coverage to more than 200,000 retirees.

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CVS Health-owned Aetna on Monday rolled out a plan design that would steer patients toward its parent company's brick-and-mortar locations — a key concern of antitrust regulators in reviewing the almost $69 billion megamerger that closed in 2019.

Under the new policy, audio-only and asynchronous telehealth services provided to Aetna self-insured/ERISA enrollees are considered non-covered services that are the responsibility of the patient, effective December 1, 2023. For more details on the new policy, click here.

NJ FamilyCare - New Jersey's publicly funded health insurance program - includes CHIP, Medicaid and Medicaid expansion populations.

According to the NJ FamilyCare/Medicaid “HMO Performance Report” released last month, Horizon NJ Health received a 92% overall performance score, the highest of all New Jersey's Medicaid managed care plans and the only plan to improve its overall score from previous reports.

We provide New Jersey FamilyCare (Medicaid) coverage. You'll get access to a wide range of benefits and services to help you reach your health goals. For complete info, see our list of covered services English (PDF) | Spanish (PDF). Or check out our member handbook.

CVS Health to Acquire Aetna; Combination to Provide Consumers with a Better Experience, Reduced Costs and Improved Access to Health Care Experts in Homes and Communities Across the Country. WOONSOCKET, R.I. and HARTFORD, Conn., Dec.

Aetna® is proud to be part of the CVS Health family.

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Most of Aetna's revenue now comes from government programs.

The two most commonly used modifiers are the GT modifier for telehealth service rendered via interactive audio and video telecommunications systems, and the 95 modifier for synchronous telemedicine service rendered via a real-time interactive audio and video communications system.

Use modifier 95 through December 31, 2024, when:

Outpatient therapy provided via telehealth by PTs, OTs or SLPs. Providers should continue to bill claims for telehealth services with the POS if the service had been done in person and modifier 95 through December 31, 2023.

Modifier 93 describes services that are provided via telephone or other real-time interactive audio-only telecommunications system. Use of this modifier is appropriate only if the real-time interaction occurs between a physician/other qualified health care professional and a patient who is located at a distant site.

Modifier 59 is used to identify procedures/services, other than E/M services, that are not normally reported together, but are appropriate under the circ*mstances.