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Precertification lists

Precertification information

 

Precertification applies to all benefits plans that include a precertification requirement. Participating providers are required to pursue precertification for procedures and services on the lists below.

 

2022 Participating Provider Precertification List – Effective date: October 1, 2022 (PDF)

 

Behavioral health precertification list – effective date: January 1, 2019 (PDF)

 

For Aetna’s commercial plans, there is no precertification required for buprenorphine products to treat opioid addiction.

 

Note: If we need to review applicable medical records, we may assign a tracking number to your precertification request. The tracking number does not indicate approval. You will be notified when a coverage decision is made.

 

Louisiana providers:

If you’re a provider in Louisiana in the process of credentialing with us — and need to find out if a service requires prior authorization — call the precertification phone number on the member’s ID card. Please don’t use the EDI process to make your request.

 

Search by CPT code

 

Use our search tool to see if precertification is required. Enter one or more 5-digit CPT codes. This tool also helps to determine if a special program applies.

 

Legal notices

Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).

Health benefits and health insurance plans contain exclusions and limitations.