What are the Aetna reimbursement rates for my state?

Understanding Aetna Rate Variability

Aetna does not use a single, universal fee schedule. Instead, reimbursement amounts are highly localized, meaning the rate is determined by the specific geographic region from which you are billing.

• The Confirmation Process: Because of this variability, CCS cannot provide a universal fee schedule with exact rates in advance. The only way to confirm your specific reimbursement is to submit and process a live claim.

  • Reimbursement amounts depend on the specific terms of the payer-provider agreement and can fluctuate based on the member's specific policy. While our internal processing benchmark for these claims is centered around paying clinicians at least $100 per session if able, please note that actual payouts vary based on the variables mentioned above.

• The CCS Fee Split: Once the insurance company establishes the rate, CCS typically retains a fee of $5–$10 per claim to cover administrative and billing costs.

• The "Test Claim" Strategy: We recommend billing an initial session to "lock in" and view the actual rate. This allows you to make an informed decision about your caseload without long-term commitment.

Your Options After the First Claim

Once your initial claim is processed and the rate is visible in your payment report, you have two choices:

1. Continue Billing: If the rate aligns with your financial needs, you can proceed with seeing Aetna clients under the CCS collective.

2. Request De-paneling: If the rate is lower than expected, you can email our team to request to be de-paneled from Aetna. Once the process is complete, you can discontinue billing them through CCS.