Effective April 9, 2020, this article is no longer current. Click HERE to read the latest about Cigna and their coverage of outpatient physical, occupational and speech therapy delivered via telehealth.
This article was updated on March 28, 2020 by adding a link to American Specialty Health and updating the place of service code to use on the 1500-claim form. In addition, it’s my interpretation that Cigna is only paying for telehealth services for physical, occupational and speech therapy submitted on a 1500-claim form by a private practice. Institutional providers (i.e. rehab agencies and hospital outpatient departments) should contact Cigna regarding telehealth coverage for physical, occupational and speech therapy services.
Cigna has announced they will cover virtual care for physical, occupational and speech therapy services through May 31, 2020. These services will be reimbursed consistent with the standard fee schedule.
Physical therapists can use CPT codes 97161, 97162 and 97110. Occupational therapists can use CPT codes 97165, 97166 and 97110. Speech-language pathologists can use CPT codes 92507 and 92526.
If submitting claims on a 1500-claim form, the place of service code would be 11 according to this document from American Specialty Health. On a UB-04 claim form, no place of service code is required. You will also have to append the GQ modifier to each CPT code on the claim form.
Click HERE to access the article and additional billing requirements.
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