The Fee Schedule Tool is accessible on our secure provider website from the Claims menu. A Security Officer must enable user access. Fee schedules are available only to directly-contracted MDs and DOs. They are not available to NaviNet® offices classified as a hospital, ancillary, IPA/PHO, those with a billing setup, or behavioral health providers who are not MDs/DOs.
Fees displayed on the site are based upon contracted amounts negotiated for the specified services. The fees reflect the amounts allowed for services as if Aetna is paying each ASA/CPT/HCPCS code on a line-by-line, fee-for-service basis. Fees do not include such factors as bundling, other coding logic, member deductibles, copayments or coinsurance.
The fee listings available on the Tool are a sample scope of services that could be provided by a participating provider. The listings do not negate or in any way supersede obligation as a participating provider to use Aetna's contracted vendors.
Please note: Fee schedule information will not display accurate rates for care services provided to Aetna members who participate in an Accountable Care Organization (ACO) arrangement. Members with an ACO arrangement will have a member ID card with an ACO logo and/or network name. Providers should use the Provider Payment Estimator tool to obtain an accurate out-of-pocket cost for these patients. Providers can access the Payment Estimator tool from the left navigation bar on Aetna Plan Central.