Cigna - Continued COVID-19 Accommodations Update for 2022

January 10, 2022

Since the COVID-19 pandemic began, Cigna has taken important steps to deliver timely accommodations to providers and customers, helping to ensure that customers have continued access to COVID-19 diagnostic services, testing, and treatment in safe settings.

Reinstituting and extending interim accommodations

With the recent surge of COVID-19 cases resulting in increased strain on providers, we are making a number of accommodations to support you.

  • The facility-to-facility transfer authorization waiver for Cigna commercial and Cigna Medicare Advantage customers has been reinstituted, and is in place effective immediately for all transferring facilities through March 31, 2022.
  • Interim credentialing accommodations are extended through March 31, 2022.
  • The authorization approval window will be extended from three months to six months on request from a provider.

Billing place of service 10 for virtual care services

CMS recently announced updates to their place of service (POS) guidelines for virtual care by revising the description of existing POS code 02 and adding new POS code 10. CMS has indicated POS 10 is effective January 1, 2022, but will not be available to bill for Medicare until April 1, 2022.

In the interim, Cigna commercial still asks providers to bill with a typical face-to-face place of service (e.g., POS 11), and to not bill POS 10 until further notice. This will help ensure that providers continue to receive face-to-face reimbursement rates. Cigna Medicare Advantage expects to align with CMS guidelines to accept POS 10 on April 1, 2022.

eConsult services remain covered, but cost-share now applies

Throughout the pandemic, we have covered certain eConsult codes without customer cost-share. Please note that while these codes continue to be covered as part of our interim COVID-19 guidelines, cost-share now applies for all commercial eConsult services, effective January 1, 2022.

We therefore encourage providers who intend to leverage an eConsult to obtain consent from their patients prior to initiating an eConsult with another provider. This will help avoid any surprise billing scenarios for your patients with commercial Cigna coverage.

Submitting vaccine administration claims for patients with Medicare Advantage plans

For 2020 and 2021, Medicare payment for COVID-19 vaccine administration for beneficiaries enrolled in Medicare Advantage plans were made through the original fee-for-service Medicare program. CMS asked providers to submit claims for administering the COVID-19 vaccine to the CMS Medicare Administrative Contractor (MAC) using product-specific codes for each vaccine approved.

However, as of January 1, 2022, providers should submit vaccine administration claims directly to Cigna Medicare Advantage for patients enrolled in a Cigna Medicare Advantage plan.

Get all the latest updates

We updated our dedicated commercial and Medicare Advantage COVID-19 website pages on December 29, 2021 to highlight these updates and more. Please visit the sites often to get the latest information.

Thank you again for the quality care you provide and for all that you’re doing to help our customers.