Cigna’s policy (through May 31, 2020):
- Customers can receive non-COVID-19 related virtual care from their provider, covered and reimbursed at standard office visit rates and customer cost-share.
- Non COVID-19 related in-office and virtual care remains at standard cost share, billing, and reimbursement requirements.
Cigna will reimburse in-person visits, phone calls, real-time synchronous virtual visits, and testing for COVID-19 without copay or cost-share for all individuals covered under a fully-insured Cigna medical benefit plan and when billed according to the following guidelines:
Phone calls for COVID-19 (e.g.: 5-10 min virtual visit with or without video with the licensed health care provider):
- HCPCS code G2012 will be reimbursed without customer copay or cost-share.
All other virtual visits
- ONLY CPT® code 99241 will be reimbursed, for all other synchronous real-time virtual visits when billed with Place of Service 11.
- If the visit is related to COVID-19, ICD10 diagnosis codes (Z03.818 or Z20.828) are required to be billed and reimbursement will be without customer copay/cost-share.
- If the virtual visit is not related to COVID-19, the ICD10 code for the visit should be billed and reimbursement will be made according to applicable benefits and related cost share.
- No virtual care modifier should be billed
Behavioral Telehealth interim guidance: