Originally set to take effect on April 1, the company said in January it planned to reimburse eligible services billed with modifiers SA or SB at 85% of the allowed amount. Modifier SA indicates that a nurse practitioner is providing a service in collaboration with a physician, while modifier SB is used for services provided by a nurse midwife. The policy was set to apply to both Aetna’s commercial and Medicare members.
On Feb. 10, Aetna said the new policy would no longer move forward and apologized for any confusion.
While nonphysician practitioners who bill directly under their own name and National Provider Identifier will still receive payment at the reduced 85% rate, the reversal means that those who bill “incident-to” a supervising physician will receive full reimbursement.
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