To access Aetna’s comprehensive Precertification Lists, which detail the procedures, programs, and drugs requiring prior authorization, please visit their official page: Aetna Precertification Lists.
On this page, you’ll find:
2025 Participating Provider Precertification List: Effective March 1, 2025.
2024 Behavioral Health Precertification List: Effective August 1, 2024.
Search by CPT Code Tool: Allows you to check if a specific procedure requires precertification.
Medical Preferred Drugs Information: Details on drugs covered under Aetna’s commercial medical benefit and their clinical drug policies.
Recent Medical Drug Coverage Changes: Updates starting January 1, 2025.
Please note that precertification applies to all benefit plans that include a precertification requirement. Participating providers are required to pursue precertification for procedures and services on these lists.
Additionally, for providers in Louisiana who are in the process of credentialing with Aetna, it’s advised to call the precertification phone number on the member’s ID card rather than using the EDI process to make your request.
When is precertification required?
Precertification applies to all benefit plans that have a precertification requirement. Participating providers need to request precertification for the procedures and services in these lists.
- 2025 precertification list – effective 06/01/2025 (PDF)
- 2024 behavioral health precertification list – effective August 1, 2024 (PDF)
If we need to review medical records for your precertification request, we may assign a tracking number to your request. This tracking number isn’t an approval. We’ll inform you when we’ve made a coverage decision.
