C1816 Insurance Policy Changes

Alzheimer's Disease: Experimental, Investigational, or Unproven Treatments (CPB 0788, reviewed 2025-11-19)

Aetna has updated its clinical policy bulletin (CPB 0788) to clarify that 70+ treatments for Alzheimer's disease remain experimental, investigational, or unproven and are not covered. The policy provides a comprehensive list of non-covered procedures and their associated billing codes, including deep brain stimulation, stem cell therapy, various immunotherapies, and pharmacological interventions. Billing teams must ensure claims for these treatments are denied or require prior authorization review based on patient coverage terms.