Cigna CPT Code Changes

In an effort to provide real-time updates about the 2019 Current Procedural Terminology (CPT®) code changes for applied behavior analysis (ABA) services, we are sharing this communication with our national network of behavioral providers.
Important CPT code information for ABA services
  • The current CPT codes utilized for ABA services will expire on December 31, 2018, and will no longer be active in Cigna claim systems.
  • For services rendered on or after January 1, 2019, please use the new CPT codes to avoid unnecessary claim denials due to expired codes.
  • Cigna will continue to allow for the billing of HCPCS Code G9012 from now until your updated fee schedule is effective.
  • There will be NO changes to your reimbursement until your updated fee schedule is effective. The rate calculation will be done automatically via the code crosswalk that appears in the November issue of Transformations
  • You can determine your reimbursement rate for each new code by cross referencing your current fee schedule with the crosswalk mentioned above.
    • For example, if you are currently receiving $20.00 for a 30-minute service, you will receive $10.00 for a 15-minute service with the 2019 CPT codes.* When submitting claims, you can list the current rate for the service on the claim form and our system will automatically calculate the rate into 15-minute units.
We are working as quickly as possible to update all impacted fee schedules. In the interim, please know that your reimbursement rates will not be lowered as a result of these changes. We remain committed to providing additional updates as they become available.
Thank you,

Network Operations Management
Cigna Behavioral Health

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