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 J1745? Open Aetna’s official lists and confirm the member’s product there.

30 policies name J1745, those listing the fewest codes first. A policy that names a code may also list it as excluded.

Aetna policies
PolicyDetailsCodesSource
Intradiscal Procedures0602 · Commercial21Original policy ↗
1091-Therapeutic Drug Monitoring of Anti-Tumor Necrosis Factor Blocking Agents1091 · Commercial23Original policy ↗
0751-Natalizumab0751 · Commercial26Original policy ↗
1013-Spesolimab-sbzo (Spevigo)1013 · Commercial28Original policy ↗
Tuberculosis Testing0471 · Commercial29Original policy ↗
1012-Tildrakizumab-asmn (Ilumya)1012 · Commercial35Original policy ↗
Rilonacept (Arcalyst)0770 · Commercial35Original policy ↗
1011-Guselkumab (Tremfya)1011 · Commercial37Original policy ↗
0881-Canakinumab (Ilaris)0881 · Commercial39Original policy ↗
0905-Secukinumab (Cosentyx)0905 · Commercial39Original policy ↗
0800-Dupuytren's Contracture: Treatments0800 · Commercial46Original policy ↗
0885-Vedolizumab (Entyvio)0885 · Commercial52Original policy ↗
Certolizumab Pegol (Cimzia)0761 · Commercial59Original policy ↗
0912-Ustekinumab0912 · Commercial61Original policy ↗
0419-Graves' Ophthalmopathy Treatments0419 · Commercial62Original policy ↗
Adalimumab0655 · Commercial62Original policy ↗
Abatacept (Orencia)0720 · Commercial64Original policy ↗
1009-Risankizumab-rzaa (Skyrizi)1009 · Commercial66Original policy ↗
Vitiligo0422 · Commercial70Original policy ↗
Alopecia Areata0423 · Commercial72Original policy ↗
Golimumab (Simponi and Simponi Aria)0790 · Commercial74Original policy ↗
0799-Tocilizumab0799 · Commercial81Original policy ↗
Infliximab0341 · Commercial92Original policy ↗
0729-Diabetic Neuropathy: Selected Treatments0729 · Commercial94Original policy ↗
0788-Alzheimer's Disease: Experimental, Investigational, or Unproven Treatment0788 · Commercial95Original policy ↗
Recurrent Pregnancy Loss0348 · Commercial109Original policy ↗
0307-Parkinson's Disease0307 · Commercial119Original policy ↗
Complex Regional Pain Syndrome (CRPS): Treatments0447 · Commercial140Original policy ↗
Participating provider precertification list for Aetna®1013000-01-35 · Effective Nov 1, 2025 · Commercial1,389Original policy ↗
Participating provider precertification list for Aetna®Effective Jan 1, 2026 · Commercial1,440Original 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.