Wiki Pt billing to aetna

[selenasta]

Does aetna pay for 4 modalites for pt and chiro or do they pay 4 units??? I am having a lot of claims denied for only 4 units. When we perform 2 units on 97110 they count it as 2 modalities.. Anyone else having this problem??

 

[cwater]

Aetna pays a maximum of 4 units of therapy per day.

Thanks,
Camille

 

[selenasta]

Thank you for your response Where are you located? We thought it was 4 modalities.

 

[gabyj1]

Per my conversation with Aetna their policy is 4 units per day. So, in theory you can only bill 1 hour since each unit is 15 minutes unless otherwise specified by the member's plan. If the member's plan does not specify it is standard Aetna policy.