Reference plan documents for a list of covered and non-covered preventive care services.ģ Health benefit plans may be different, but in general to be eligible for coverage a drug must be approved by the Food and Drug Administration (FDA), prescribed by a health care professional, purchased from a licensed pharmacy, and be medically necessary. Some preventive care services may not be covered, including most immunizations for travel. Includes eligible in-network preventive care services. For IL customers, a primary care provider referral may be required for specialist virtual visits.Ģ Availability of $0 preventive care (no cost share) by plan may vary. Refer to plan documents for complete description of virtual care services and costs, including other telehealth/telemedicine benefits. Virtual care does not guarantee that a prescription will be written. HSA plans and non-minor acute medical care may apply a copay, coinsurance, or deductible.
$0 virtual care benefit (no cost share) for minor acute medical care not available for all plans. This service is separate from your health plan’s network and may not be available in all areas. Video chat may not be available in all areas or with all providers. Providers are solely responsible for any treatment provided to their patients. For Texas residents, health plans are offered by Cigna HealthCare of Texas, Inc.ġ Cigna Healthcare provides access to dedicated virtual care through a national telehealth provider, MDLive located on m圜igna, as part of your health plan. For South Carolina residents, health plans are offered by Cigna HealthCare of South Carolina, Inc. For North Carolina residents, health plans are offered by Cigna HealthCare of North Carolina, Inc. For Illinois residents, health plans are offered by Cigna HealthCare of Illinois, Inc. For Georgia residents, health plans are offered by Cigna HealthCare of Georgia, Inc. Except for the specific phone-only codes, services must be interactive and use both audio and video internet-based technologies (i.e., synchronous communication).Plans are insured by Cigna Health and Life Insurance Company or its affiliates: For Arizona residents, health plans are offered by Cigna HealthCare of Arizona, Inc.Physicians should instead bill a typical face-to-face place of service (e.g., POS 11) to ensure they receive the same payment rate as they typically get for an in-person visit. Billing POS 02 for virtual services may result in reduced payment or denied claims.Modifier 95, GT, or GQ must be appended to the virtual care code(s).Claims must be submitted on a CMS-1500 form or electronic equivalent.Services must be one of the eligible codes listed in the new virtual care policy.The following general requirements must be met for Cigna to consider paying for a virtual care visit: Annual wellness visit codes (G0438 and G0439).Outpatient E/M codes for new and established patients (99202-99215).The policy provides continued payment for virtual services that are typically performed in an office setting.Ĭommon services included in the policy include:Ĭommon codes included in the policy include: UnitedHealthcare has also changed its telehealth policies recently.Ĭigna’s new policy applies to services provided to commercial medical customers, including those with Individual & Family Plans (Cigna Behavioral Health and Cigna Medicare Advantage customers will continue to have virtual care services covered through their own separate benefit plans). The policy builds on billing and coding flexibilities spurred by COVID-19. Cigna, one of the country’s largest private health insurers, has implemented a new virtual care reimbursement policy as of Jan.
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