P2P Call Guide

How to Win a P2P Call for Inpatient Rehabilitation Facility (IRF) Denied by Aetna

Payer-specific strategy, medical necessity arguments, and the exact phrases to use when Aetna denies Inpatient Rehabilitation Facility (IRF) (CPT 97110, 97140, 97530).

Why Aetna Denies Inpatient Rehabilitation Facility (IRF)

Patient does not require 3 hours/day therapy intensity

Skilled nursing facility is appropriate alternative

Medical complexity does not warrant IRF level

Know Aetna's Criteria

Aetna uses their own Clinical Policy Bulletins (CPBs) and InterQual criteria. CPBs are publicly available and numbered.

Key policies to know:

  • Clinical Policy Bulletins (CPBs) are publicly available and numbered
  • Uses eviCore for radiology and cardiology prior auth
  • Known for detailed, evidence-based CPBs with specific criteria
  • Precertification list updated annually

Building Your Medical Necessity Argument

Document ability to participate in 3+ hours/day of therapy

List qualifying diagnoses under the 60% rule

Note medical complexity requiring physician supervision

Explain why SNF level is insufficient for this patient

P2P Call Tips for Aetna

Reference the specific CPB number and criteria being met

Aetna CPBs are very detailed -- read them before the call

Address each specific criterion in the CPB during the P2P

Aetna medical directors are typically receptive to guideline-based arguments

Guidelines to Reference

  • CMS IRF Coverage Requirements (60% Rule)
  • InterQual Criteria for Rehabilitation Facility Admission

Relevant CPT Codes

CPT 97110CPT 97140CPT 97530

Specialty: Physical Medicine & Rehabilitation

Want the full strategy?

The P2P Playbook covers payer-specific approaches for Inpatient Rehabilitation Facility (IRF) denied by Aetna -- plus 15 denial objections with word-for-word responses, what reviewers are actually thinking, and the 60-second prep framework. Written by a medical director who reviewed cases for major payers.

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