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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Early Intervention Services (EIS) Webinar Presentation

Early Intervention Services Snapshot

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.