I just got off of the phone with Aetna’s Senior Medical Director for Southeast U.S.
Good news! He says Aetna is covering telehealth well checks! However, the way they want it is a bit different than other payors.
The first portion of the well check which is done by telehealth should be billed as an telehealth OFFICE VISIT (99212-99215) with -95 modifer and place of service -02.
The second portion of the well check which must include the PHYSICAL EXAM should be billed with the normal well check codes (99391-99385, 99391-99395). No special modifiers for that visit.
This is the opposite of what several other payors want, but the good news, is that as long as all the kids actually return to your office then you are being paid for all the work that you have done!
Their systems are already set up to process this, so it is effective immediately. He is going to work on getting official Aetna policy out to make this clear to everyone.