CommercialCoverageMedium impact
Complementary and Alternative Medicine (CPB 0388, reviewed 2026-06-25)
Aetna·Chiropractic, Pain Management, Physical Therapy +1 more·Medical Policy
Effective date
Jun 25, 2026
We identified it
Aug 15, 2026
Summary
Aetna has updated its Complementary and Alternative Medicine policy (CPB 0388, effective 2026-06-25) clarifying coverage and non-coverage for CAM services. The policy maintains coverage for evidence-based CAM interventions (acupuncture, biofeedback, chiropractic, electrical stimulation) while designating a comprehensive list of unproven therapies as experimental/investigational and therefore non-covered. Billing teams must immediately update claim denial protocols and ensure proper coding for the few covered CAM services with specific CPT codes.
Action Required
By 2026-06-25, billing team must: (1) Update claim submission rules in billing software to DENY all claims for the 150+ experimental/investigational CAM treatments listed in the policy (including colonic lavage, intravenous vitamin C infusions, reiki, chelation for atherosclerosis, etc.); (2) Ensure CPT 0736T (colonic lavage) and 0771T (virtual reality procedural dissociation) are flagged as non-covered per this policy; (3) Maintain coverage only for referenced policies: CPB 0011 (electrical stimulation for pain), CPB 0107 (chiropractic), CPB 0132 (biofeedback), CPB 0135 (acupuncture/dry needling), CPB 0234 (chelation therapy—excluding atherosclerosis), CPB 0240 (antineoplastons), and CPB 0151 (hippotherapy); (4) Add deny reason code referencing CPB 0388 to all rejections for unlisted CAM services; (5) Instruct front-desk and coding staff to educate members that nutritional supplements (fish oil, glucosamine, St. John's wort, etc.) are excluded from standard benefit plans and are patient responsibility; (6) Communicate to providers that medical marijuana remains non-covered as it is not FDA-approved. Failure to implement denials will result in inappropriate claim payments and recovery actions from Aetna.