MedicaidPrior AuthHigh impact
Provider Letter 2025-09: RE: Aetna Beter Health of Oklahoma’s Implementation of PA Requirements for Specific Codes
Oklahoma SoonerCare·OK · Cardiology, Orthopedics, Neurosurgery +2 more·Provider Letter
Effective date
Apr 1, 2025
We identified it
Jun 20, 2026
Summary
Aetna Better Health of Oklahoma is implementing new prior authorization requirements for specific cardioversion procedures, surgical procedures, DME, and nerve injection codes effective April 1, 2025. These codes previously did not require prior authorization through OHCA but will now require prior auth for Aetna Better Health of Oklahoma Medicaid members.
Action Required
By April 1, 2025: Billing team must update prior authorization protocols for Aetna Better Health of Oklahoma members for the following codes: 93304, 93303, 93351, 93350, 22325, 21199, E0935, E0730, and 61640. Update billing system to flag these codes for prior auth requirement. Train staff to obtain prior authorization before providing these services. Contact Aetna Better Health at 844-365-4385 for prior auth requests. Claims will likely be denied without proper prior authorization.