Payer policies
Aetna clinical policy bulletins and precertification lists
Aetna's coverage policy lives in its Clinical Policy Bulletins (CPBs). Medical CPBs are numbered with four digits and can be browsed alphabetically or by category, with a list of what is new and what is under periodic review. Pharmacy CPBs are published separately alongside Aetna's formularies.
Precertification is published as its own list for commercial and Medicare plans, with a CPT code lookup. Aetna's Medicaid plans, under Aetna Better Health, publish clinical guidelines and policy bulletins state by state.
Where Aetna publishes its policies
Official Aetna pages, checked Oct 25, 2026. Policies change often; always read the version on the payer's site for your date of service.
Clinical Policy Bulletins
Aetna's entry point to its medical and pharmacy CPBs.
Medical policyMedical Clinical Policy Bulletins
Medical CPBs, searchable by four-digit CPB number and listed by title and category.
Drug policyPharmacy Clinical Policy Bulletins
Formularies and pharmacy CPBs.
Prior authorizationPrecertification lists
Precertification lists for Medicare and commercial plans, with a CPT code lookup and medical preferred-drug information.
Medicare AdvantageMedicare resources for providers
Aetna's Medicare Advantage provider resources.
Medicare AdvantageMedicare Part B drug requirements
Part B drug coverage and step therapy requirements for Medicare plans.
Aetna in RCIntel
RCIntel's policy library includes Aetna's medical Clinical Policy Bulletins. You can query them over the API and MCP, or upload any Aetna policy, including pharmacy CPBs, to Payer Intelligence for cited answers.
Ask a Aetna policy a question
Upload a Aetna policy to Payer Intelligence and ask it what you need to know. Every answer cites the section and page it came from.
Common questions
What is an Aetna Clinical Policy Bulletin?
A CPB is Aetna's published policy on a service, device or drug: when Aetna considers it medically necessary and when it does not. Each medical CPB has a four-digit number.
When do Aetna's precertification list changes take effect?
Aetna's precertification page says changes to the commercial medical drug list take effect in January, April, July and October. Check the list for the date it was last updated.
Where are Aetna's payment policies?
Aetna does not publish a public payment policy index the way it does CPBs. Its claims, payment and reimbursement page covers fee schedules, payments and disputes, and payment policy changes are announced in Aetna's provider newsletter.