Aetna policies, page 33

Search Aetna's public medical, payment and drug policies by CPT or HCPCS code, keyword or policy number, with links to the payer's own documents. Links open the payer's own document; check its current version before relying on it.

5,481 public policies Substrate tracks for Aetna, by title.

Aetna policies
PolicyDetailsCodesSource
[Pharmacy] Flector, Licart Limit 349-H P06-2025 - Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan349-H · Commercial—Original policy ↗
[Pharmacy] Flector, Licart Limit Policy 349-H 06-2023 - Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan349-H · Commercial—Original policy ↗
[Pharmacy] Flector, Licart Limit Policy 349-H 06-2023 - Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan349-H · Commercial—Original policy ↗
[Pharmacy] Flector, Licart Limit Policy 349-H 06-2023 - Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan349-H · Commercial—Original policy ↗
[Pharmacy] Follitropins 1914-A, 1915-A SGM P2023 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan1914-A, 1915-A · Commercial—Original policy ↗
[Pharmacy] Follitropins 1914-A, 1915-A SGM P2023 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan1914-A, 1915-A · Commercial—Original policy ↗
[Pharmacy] Follitropins 1914-A, 1915-A SGM P2024 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan1914-A, 1915-A · Commercial—Original policy ↗
[Pharmacy] Follitropins 1914-A, 1915-A SGM P2024 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan1914-A, 1915-A · Commercial—Original policy ↗
[Pharmacy] Forteo-Teriparatide-Bonsity 2028-A SGM P2021 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan2028-A · Commercial—Original policy ↗
[Pharmacy] Forteo-Teriparatide-Bonsity 2028-A SGM P2022a - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan2028-A SGM P2022a · Commercial—Original policy ↗
[Pharmacy] Forteo-Teriparatide-Bonsity 2028-A SGM P2022a - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan2028-A SGM P2022a · Commercial—Original policy ↗
[Pharmacy] Forteo-Teriparatide-Bonsity 2028-A SGM P2022a - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan2028-A SGM P2022a · Commercial—Original policy ↗
[Pharmacy] Foundayo PA with Limit 7433-C P04-2026 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan7433-C · Commercial—Original policy ↗
[Pharmacy] Fruzaqla 6246-A SGM P2023a - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan6246-A · Commercial—Original policy ↗
[Pharmacy] Fruzaqla 6246-A SGM P2023a - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan6246-A · Commercial—Original policy ↗
[Pharmacy] Fruzaqla 6246-A SGM P2023a - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan6246-A · Commercial—Original policy ↗
[Pharmacy] Fruzaqla 6246-A SGM P2023a - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan6246-A · Commercial—Original policy ↗
[Pharmacy] fulvestrant-Faslodex 2903-A SGM P2022 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan2903-A · Commercial—Original policy ↗
[Pharmacy] fulvestrant-Faslodex 2903-A SGM P2022 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan2903-A · Commercial—Original policy ↗
[Pharmacy] fulvestrant-Faslodex SGM 2903-A P2025 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan2903-A · Commercial—Original policy ↗
[Pharmacy] fulvestrant-Faslodex SGM 2903-A P2026a - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan2903-A P2026a · Commercial—Original policy ↗
[Pharmacy] Fuzeon 3099-A SGM P2022 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan3099-A · Commercial—Original policy ↗
[Pharmacy] Fuzeon 3099-A SGM P2023 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan3099-A · Commercial—Original policy ↗
[Pharmacy] Fuzeon 3099-A SGM P2024 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan3099-A · Commercial—Original policy ↗
[Pharmacy] Fuzeon SGM 3099-A P2025 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan3099-A · Commercial—Original policy ↗
[Pharmacy] Fuzeon SGM 3099-A P2025 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan3099-A · Commercial—Original policy ↗
[Pharmacy] Gabapentin IR Limit, Post PA 2970-HJ P06-2025 - Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan2970-HJ P06-2025 · Commercial—Original policy ↗
[Pharmacy] Gabapentin IR Limit, Post PA Policy 2970-HJ 06-2022 - Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan2970-HJ · Commercial—Original policy ↗
[Pharmacy] Gabapentin IR Limit, Post PA Policy 2970-HJ UDR 06-2023 - Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan2970-HJ · Commercial—Original policy ↗
[Pharmacy] Gabapentin IR Limit, Post PA Policy 2970-HJ UDR 06-2024 - Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan2970-HJ · Commercial—Original policy ↗
[Pharmacy] Galafold 2650-A SGM P2021 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan2650-A · Commercial—Original policy ↗
[Pharmacy] Galafold 2650-A SGM P2023 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan2650-A · Commercial—Original policy ↗
[Pharmacy] Galafold 2650-A SGM P2024 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan2650-A · Commercial—Original policy ↗
[Pharmacy] Galafold 2650-A SGM P2024 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan2650-A · Commercial—Original policy ↗
[Pharmacy] Galafold 2650-A SGM P2024 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan2650-A · Commercial—Original policy ↗
[Pharmacy] Gattex 1838-A SGM P2021 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan1838-A · Commercial—Original policy ↗
[Pharmacy] Gattex 1838-A SGM P2023 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan1838-A · Commercial—Original policy ↗
[Pharmacy] Gattex 1838-A SGM P2024 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan1838-A · Commercial—Original policy ↗
[Pharmacy] Gattex 1838-A SGM P2024 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan1838-A · Commercial—Original policy ↗
[Pharmacy] Gavreto 4206-A SGM P2021 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan4206-A · Commercial—Original policy ↗
[Pharmacy] Gavreto 4206-A SGM P2022 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan4206-A · Commercial—Original policy ↗
[Pharmacy] Gavreto 4206-A SGM P2023 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan4206-A · Commercial—Original policy ↗
[Pharmacy] Gavreto 4206-A SGM P2023 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan4206-A · Commercial—Original policy ↗
[Pharmacy] Gavreto SGM 4206-A P2024_R - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan4206-A P2024_R · Commercial—Original policy ↗
[Pharmacy] Gavreto SGM 4206-A P2024_R - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan4206-A P2024_R · Commercial—Original policy ↗
[Pharmacy] gefitinib-Iressa 1660-A SGM P2023a - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan1660-A · Commercial—Original policy ↗
[Pharmacy] gefitinib-Iressa 1660-A SGM P2024 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan1660-A · Commercial—Original policy ↗
[Pharmacy] gefitinib-Iressa 1660-A SGM P2024 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan1660-A · Commercial—Original policy ↗
[Pharmacy] gefitinib-Iressa 1660-A SGM P2024 - Specialty Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan1660-A · Commercial—Original policy ↗
[Pharmacy] Gemtesa ST with Limit, Post PA (Aetna FI ACF Only) 5124-E P05-2025 - Pharmacy Clinical Policy Bulletins Aetna Non-Medicare Prescription Drug Plan5124-E · Commercial—Original policy ↗

Back to Aetna · Aetna prior authorization CPT list

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.