Aetna Fee Schedule Changes June 11, 2012 News, Payment fee schedule change, Aetna 0 In April, Aetna made changes to its fee schedule for its commercial lines of business. Although Aetna initially stated that the change would only affect Northern California physicians, SFMS has recently learned that the changes were applied statewide. In a December letter, Aetna informed physicians that it would be modifying physician reimbursement rates based on the service location zip code of the rendering physician. Physicians within specified geographical areas will be will be broken into payment regions based on their county and corresponding zip codes as assigned under the Medicare Geographical Practice Cost Index (GPCI). To help physicians understand their rights when a health plan has sent notice of a material change to a contract, SFMS/CMA has published Contract Amendments: An Action Guide for Physicians. The guide includes a discussion of options available to physicians when presented with a material change to a contract and can be found on the member-only section by clicking here. Practices with questions about the new reimbursement rates can contact Aetna Provider Service Center at (888) 632-3862. If you are a SFMS member with billing and contract issues, please contact our reimbursement helpline at (888) 401-5911. Comments are closed.
