After much discussion with physician advocacy groups, Aetna has determined that it will pay two E&M Codes on the same day, using the 100/50 “concurrency rule.” The preventive medicine visit will be considered the primary service payable at 100% of the allowable, and the eligible office (or problem-focused) E&M visit will be considered the secondary service payable at 50% of the allowable.
Aetna Agrees to Pay Two E&M Services on the Same Day
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