Cigna policy
Range of Motion Testing
Range of Motion Testing is a public Cigna policy (policy CPG146, effective Jun 15, 2026). It lists 8 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
View the original policy (PDF) ↗
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- Payer
- Cigna
- Policy number
- CPG146
- Effective
- Jun 15, 2026
- Line of business
- Commercial
- Source
- static.cigna.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes. Open official prior authorization lists to check the member’s product.
| Code | Other Cigna policies |
|---|---|
| 95851 | Policies naming 95851 |
| 95852 | Policies naming 95852 |
| 97161 | Policies naming 97161 |
| 97163 | Policies naming 97163 |
| 97164 | Policies naming 97164 |
| 97165 | Policies naming 97165 |
| 97167 | Policies naming 97167 |
| 97168 | Policies naming 97168 |