Cigna policies

Search Cigna's public medical, payment and drug policies by CPT or HCPCS code, keyword or policy number, with links to the payer's own documents. Links open the payer's own document; check its current version before relying on it.

Checking prior authorization for 99215? Open Cigna’s official lists and confirm the member’s product there.

2 policies name 99215, those listing the fewest codes first. A policy that names a code may also list it as excluded.

Cigna policies
Policy	Details	Codes	Source
Patient Assessments: Medical Necessity Decision Assist Guideline for Evaluations and Re-evaluations	CPG111 · Effective Jul 15, 2026 · Commercial	35	Original policy ↗
E&M1 CODES NOT REIMBURSABLE ON OUTPATIENT FACILITY CLAIMS	R12 · Effective Jul 15, 2019 · Commercial	95	Original policy ↗

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Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.