As the
COVID-19 vaccines continue to be distributed across the
country, we are committed to ensuring providers have the
latest information related to our response to COVID-19.
The following information outlines some of the latest
updates, including increased vaccine reimbursement,
encouraging patient vaccinations, our coverage of
COVID-19 tests, and accommodations we continue to make
during the public health emergency (PHE)
period.
Increased
reimbursement for COVID-19 vaccine administration
To
align with the recent CMS
update to
increase reimbursement for COVID-19 vaccine
administration, we have also increased our reimbursement
for COVID-19 vaccine administration to $40 per dose for
claims with dates of service on and after March 15, 2021
when submitted under Cigna commercial medical benefit
plans.
For
additional information on our coverage and reimbursement
of the COVID-19 vaccine, please review our
guidelines
at-a-glance flyer or visit our updated
provider
COVID-19 web page at CignaforHCP.com.
Encouraging
patients to get
vaccinated Health care
providers remain the most trusted
source of information for consumers who are hesitant
about receiving the vaccine. That’s why we encourage
you to proactively educate your
patients - especially those who may have vaccine
hesitancy or who are at high-risk of severe COVID-19
illness - on the safety, effectiveness, and
availability of the vaccine.
To
support these conversations with patients, we have
created a flyer in English
and Spanish
that answers key questions patients are likely to have
about the COVID-19 vaccines. We encourage you to share
these flyers with your patients, as
needed.
Updated coverage
criteria for COVID-19
testing In compliance with
recent federal
agency guidance, Cigna covers
individualized COVID-19 diagnostic tests without
cost-share through April 20, 2021 for asymptomatic
individuals when referred by or administered by a
health care provider. Also in alignment with federal
guidance, we do not generally cover testing for public
health surveillance, employment purposes, or for other
purposes not primarily intended for individualized
diagnosis or treatment of COVID-19.
For
additional information about Cigna's coverage of
diagnostic COVID-19 tests, and for a full outline of our
coverage criteria, please visit our updated provider
COVID-19
web page or review our updated
COVID-19
In Vitro Diagnostic Testing coverage
policy.
Additional
provider accommodations Since
the COVID-19 pandemic began, we have taken important
steps to deliver timely accommodations to providers and
customers. With this, we have extended our
accommodations related to provider credentialing until
the end of public health emergency (PHE) period,
currently through April 20, 2021.
Additionally,
please know that we recently ended our accommodations
related to authorizations. As of April 1, 2021, Cigna
resumed standard prior authorization timelines and
requirements, except where state mandates may
apply.
Please
note, however, that we consider a provider’s failure to
request an authorization due to COVID-19 an extenuating
circumstance in the same way we view care provided
during or immediately following a natural catastrophe
(e.g., hurricane, tornado, fires, etc.). Therefore, we
will not enforce an administrative denial for failure
to secure authorization (FTSA) on appeal if an
extenuating circumstance due to COVID-19 applied. In
such cases, we will review the services provided on
appeal for medical necessity to determine appropriate
coverage.
Get all the
latest updates We updated our
dedicated COVID-19
provider web page on April 6, 2021 to
highlight all of these latest updates. We encourage you
to visit the site to get these updates and
more.
Thank
you again for the quality care you provide and for all
that you're doing to help our customers.
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