New Policy Updates - Clinical Payment Coding and Policy Changes effective January 1, 2026
Aetna Better Health of Virginia implemented six new clinical payment and coding policies effective January 1, 2026, establishing diagnosis requirements and billing restrictions for cerumen removal, outpatient consultations, coronary FFR testing, immunization administration, SDOH risk assessments, thyroid testing, and serum iron studies. Billing teams must implement claims edits to enforce these restrictions or face claim denials.