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Aetna policies

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.

Checking prior authorization for 96416? Open Aetna’s official lists and confirm the member’s product there.

11 policies name 96416, those listing the fewest codes first. A policy that names a code may also list it as excluded.

Aetna policies
PolicyDetailsCodesSource
0903-Trabectedin (Yondelis)0903 · Commercial7Original policy ↗
0898-Necitumumab (Portrazza)0898 · Commercial8Original policy ↗
ADAMTS13 Assay for Thrombotic Thrombocytopenic Purpura (TTP)0780 · Commercial15Original policy ↗
0940-Mogamulizumab-kpkc (Poteligeo)0940 · Commercial19Original policy ↗
0971-Sacituzumab govitecan-hziy (Trodelvy)0971 · Commercial19Original policy ↗
Enfortumab Vedotin-ejfv (Padcev)0967 · Commercial21Original policy ↗
0675-Bortezomib Products0675 · Commercial23Original policy ↗
Pemetrexed Products0687 · Commercial35Original policy ↗
0904-Daratumumab (Darzalex) and Daratumumab and Hyaluronidase-fihj (Darzalex Faspro)0904 · Commercial39Original policy ↗
Atezolizumab (Tecentriq) and Atezolizumab and Hyaluronidase-tqjs (Tecentriq Hybreza)0909 · Commercial46Original policy ↗
0890-Pembrolizumab Products (Keytruda and Keytruda Qlex)0890 · Commercial82Original 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.

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