We consider certain laboratory tests to be experimental and investigational. These noncovered laboratory tests are not covered by most of our plans. This means your patient may be responsible for the full cost of these laboratory tests.
There are several tests that Aetna® may not cover, but the most common are:
Information you should share with patients
It is important that your patients understand that they are financially responsible for these tests, as they are noncovered services. Please remind them at the time you order the test that they are responsible for the full cost of the laboratory tests.
You can verify if we cover a lab test
We provide an online reference tool listing laboratory tests that are considered experimental and investigational or that may be conditionally covered. Access this tool on our provider website. You can also view our corresponding Clinical Policy Bulletins (CPBs), which we post alongside the CPT® code descriptions.
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Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.
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Each main plan type has more than one subtype. Some subtypes have five tiers of coverage. Others have four tiers, three tiers or two tiers. This search will use the five-tier subtype. It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. Do you want to continue?