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National Carrier · Hartford, Connecticut
Facility Credentialing & Network Participation
Aetna, a CVS Health company, is one of the nation's leading diversified health care benefits companies, serving approximately 39 million members. The integration with CVS Health creates unique opportunities for integrated behavioral health delivery through retail health locations.
Aetna payer facts
Market context
Strong presence in commercial insurance with growing Medicare Advantage and Medicaid managed care segments. Particularly strong in employer-sponsored coverage.
Payer guide
Aetna offers comprehensive behavioral health benefits with a focus on integrated care, leveraging CVS Health resources. Coverage includes residential treatment, PHP, IOP, and detox services for facilities.
All treatment settings accepted by Aetna
What sets Aetna apart
Required credentials for network participation
Prior Authorization
Medical Necessity Criteria
ASAM criteria for substance use; ABA Medical Necessity Guide for behavioral health; LOCUS/CALOCUS/CASII for level of care determinations
Payment and billing information
Coverage area
49 states nationwide
Corporate Headquarters
Hartford, Connecticut
Continue learning
Provider guide
Learn what insurance credentialing is, why it matters, and how to navigate the process to get in-network.
Read moreProvider guide
A practical step-by-step guide for healthcare providers who want to join insurance panels.
Read moreProvider guide
Navigate behavioral health carve-outs and credentialing requirements for major payers.
Read moreProvider guide
Learn how payer contracts work and how to negotiate better reimbursement rates.
Read moreExpert contracting support
Our team specializes in Aetna contracting for behavioral health facilities. We'll help you secure competitive rates and streamline your credentialing process.
Achieve significantly better reimbursement through expert negotiation
Reduce credentialing timeline from months to weeks
CAQH, state licensing, and accreditation guidance
Your personal contracting specialist throughout the process