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Effective January 1, 2018, CPT code 97532 (cognitive skills development, each 15 minutes) will be removed and replaced with CPT code 97127 (Therapeutic interventions that focus on cognitive function and compensatory strategies to manage the performance of an activity, direct (one-on-one) patient contact). Billing providers should advise their therapist and billing staff of these changes.
The SFA has noticed an increase in Aetna rejections due to provider or therapist NPI number not being registered with Aetna. Please follow the link to register your NPI number with Aetna. You may choose to send in five or fewer at a time or request a spreadsheet to submit more than 6 at a time. This will ensure that your claims will be accepted and adjudicated by Aetna.
The SFA has seen a large increase in rejections for claims sent to Beacon Health Options. Providers that have children with Beacon Health Options (formerly Value Options) for which the claims address used to be PO Box 1800 in Latham, NY, the address has now changed, so please select Beacon Health 600475 in NYEIS with the P.O. Box 1850, Hicksville, NY 11802-1850.
Want to check if a referring provider is enrolled as an OPRA provider? Check a rendering therapists' NPI? Look up an 835 Denial Code? Follow the link for these and more useful links.