Aetna (Medicare) does not cover CPT 97001 PT Evaluation

[Guest guest]

We just checked the benefits of a patient referred to

us for Wound Care. His primary is Aetna (Medicare).

He used to have Medicare primary and Aetna as his

secondary. The clerk at the benefits desk asked what

CPT codes we would be using. She advised us the CPT

97001- PT Evaluation was not covered. Whirlpool was

not covered, but both selective and non-selective

wound care were covered. I called again because I

could not believe that the Evaluation was not covered.

The second clerk verified that information. I do

plan to write a letter to Aetna and to speak to

someone at APTA. Just thought I would get this info

out to the list serves I belong to.

Pat Cornwell

Palos Community Hospital

Palos Heights, Illinois

Pat Cornwell

Dir. of Rehab Services

Palos Community Hospital

Palos Heights, Illinois

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