Aetna Better Health of Ohio, with our partnership with CMS and Medicaid, continues to address medical cost savings initiatives where appropriate. To stay current with the national coding standards, we are updating our current modifier discount tables to align with those national guidelines. Listed below are the Medicare modifiers Aetna Better Health of Ohio is implementing on 1/1/18. This will allow our provider network time to adjust and make changes as needed.
If you have further questions about this modifier table please reach out to us by email at [email protected] or by phone at 1-855-364-0974 option 2, then option 5.
Modifier
Description
Current Discount
New Discount
52
Reduced Services
0%
50%
53
Discontinued Procedure
0%
20%
54
Surgical Care Only
0%
75%
55
Postoperative Management Only
0%
15%
56
Preoperative Management Only
0%
10%
73
Discontinued Outpatient Procedure Prior to the Administration of Anesthesia
0%
50%
74
Discontinued Outpatient Procedure After Administration of Anesthesia
0%
50%
78
Unplanned Return to Operating/Procedure Room by the Same Physician or other Qualified Health Care Professional Following Initial Procedure for Related Procedure During Postoperative Period
0%
70%
95
Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system
0%
75%
AS
Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery
16%
14%
GT
Service Provided Via Interactive Audio and Video Telecommunications Systems
