Document Library
For your convenience, Aetna Better Health of Florida has compiled the most frequently used documents in one location. This collection of files and forms is available to you from our health plans. Here you will find provider manuals, formularies, pre-certification requirements, and other supporting documentation to help you provide superior service to our members. If you wish, you may view, print, or store these files below for your future reference.
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Coronavirus Disease 2019 (COVID-19)
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Claims Information
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Early Intervention Services (EIS)
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Early Intervention Services (EIS) Webinar Presentation
Early Intervention Services (EIS) Reference Guide
Effective 04/01/2020, Aetna Better Health of Florida will implement changes on the way that Early Intervention Services (EIS) Therapy claims are billed. TL Modifier will be required in order to ensure that claims are paying with the correct reimbursement fee when billing Physical Therapy (PT), Occupational Therapy (OT) and Speech-Language Therapy (ST) Treatment and Assistance claims.
Please review the table below for details about the codes that require the TL Modifier when billing Aetna Better Health of Florida.
Prior Authorization for these services will NOT be required if claims are submitted with the TL modifier for EIS members.
Early Intervention Services (EIS) – Billing Therapy with TL Modifier
Therapy Service
Code
Aetna NEW Required Modifier
Description
Maximum Allowable
Units
Physical Therapy
97110
TL
Physical Therapy Treatment Visit
4 per day, 14 per week
Physical Therapy
97110
TL
Physical Therapy Visit Provided by a Physical Therapy Assistant
4 per day, 14 per week
Occupational Therapy
97530
TL
Occupational Therapy Treatment Visit
4 per day, 14 per week
Occupational Therapy
97530
TL
Occupational Therapy Visit Provided by an Occupational Therapy Assistant
4 per day, 14 per week
Speech-Language Therapy
92507
TL
Speech Therapy Visit
4 per day, 14 per week
Speech-Language Therapy
92508
TL
Group Speech Therapy per child in the group per 15 minutes
4 per day, 14 per week
Speech-Language Therapy
92507
TL
Speech Therapy Visit Provided by a Speech Therapy Assistant
4 per day, 14 per week
NOTE: The TL modifier is to be used only for therapy associated with an IFSP.
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Flu Information
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Hospice Information
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Laboratory and Pathology
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Medical Foster Care Services
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Negative Balance Collection Remittance
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Oral Health