RateTier
A tri-state (High, Mid, Low) indication of whether a rate is an MD (High), PhD/NP (Mid), or MA (Low) rate.
Our system will only label the rate tier associated with the maximum npi-list-length.
Aetna will often copy/paste the same NPI list for multiple rate tiers for a given code and billing class. This helper column aims to disambiguate Aetna rates for all 9 codes (CPT codes that start with a 9). Read more here about our Aetna rate tier feature.
| RateTierS | |
|---|---|
| Description | A tri-state (High, Mid, Low) indication of whether a rate is an MD (High), PhD/NP (Mid), or MA (Low) rate.Our system will only label the rate tier associated with the maximum npi-list-length.Aetna will often copy/paste the same NPI list for multiple rate tiers for a given code and billing class. This helper column aims to disambiguate Aetna rates for all 9 codes (CPT codes that start with a 9). Read more here about our Aetna rate tier feature. |
| Methodology | A rate tier is only included if there's a presence of at least 2 out of 3 rates that follow the 100%-85%-75% rate ladder. Otherwise, the rate tier value is blank.Rate tier calculation:
|
| Category | Rate & Arrangement |
| Source | Added or derived by Serif Health |
Other Rate & Arrangement fields
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