Aetna Allows for In-Network Supervisory Billing

Do you get the Aetna Officelink newsletters? If not, here's the link for past newsletters.

I saw an important update when looking through the email:

Aetna now allows for supervisory billing for in-network behavioral health! This seems to not apply for those out of network. 

Someone from my FB group called to inquire about this and here's what they heard from Aetna: 

"From what I could get from the rep on the phone a group needs to send a letter of intent to link those providers with the organization (if you have already done this, you are good to go to bill). Once that letter of intent is approved, you are good to go.  Of course, it will take them 60 days to approve...I mean, they ask you to wait 60 days for approval.

Per the article:

"Aetna Behavioral health supervisory billing

Aetna® recognizes that high consumer demand for behavioral health services affects its behavioral health network. As part of our effort to support our providers and improve member access to care, Aetna allows supervisory billing for behavioral health care provided by qualified license-eligible behavioral health clinicians.

Note that we will allow supervisory billing only for in-network behavioral health clinicians, supervisors, groups and facilities.

Note that we will allow supervisory billing only for in-network behavioral health clinicians, supervisors, groups and facilities.

What is a qualified license-eligible clinician?

Qualified license-eligible clinicians:

• Have completed all educational requirements for their target license type
• Are actively completing their clinical practice hours required for independent licensure
• Are actively receiving clinical supervision from a qualified supervisor at a frequency and duration commensurate with their caseload

Example: A clinician graduates with a master’s degree in counseling psychology. She has completed all required educational credit hours to sit for her state licensure exam as a Licensed Independent Social Worker (LICSW). She is required to work a minimum number of clinical hours and receive regular clinical supervision prior to taking the exam. She is eligible for supervisory billing if she receives regular supervision from a qualified clinical supervisor.

What is a qualified clinical supervisor?

Qualified clinical supervisors are independently licensed behavioral health providers actively credentialed and contracted with Aetna individually and/or under a contracted behavioral health group or facility.

Example: A supervisor at a Community Mental Health Center (CMHC) provides regular clinical supervision for master’s level, license-eligible employees.

How to manage claims

Providers may submit claims for services delivered by license-eligible clinicians by listing the licensed supervisor as the rendering clinician. The services rendered must be covered under the member’s benefits plan and an individual, group or facility contract with Aetna.

Prior authorization is not required for routine outpatient services such as psychotherapy and medication management.

Read the article here. Ok, Aetna, ok!