Cigna Updates Physical Therapy Coverage Policy

March 8, 2021
Rick Gawenda

Cigna has updated their medical coverage policy for outpatient physical therapy services. The effective date for the revised policy is

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  1. As always, thank you Rick for keeping us updated with the latest changes in outpatient rehab.

  2. Rick.
    Thanks for the update! We have run into an isolated issue with Humana PPO – Commercial plan (is what our billing Dept has told me). This particular Humana plan has authorized surgery and PT pre-op and has now decided to recind payment and denying PT payment based on coding. Our billing manager has been losing sleep over this for a week now. NO ONE at Humana has been able to figure it out either. Including supervisors.
    Fortunately today , she found a 2 minute video clip about the way Humana wants the coding performed effective 1/2021. They’re requiring both the GP and 97 modifiers in order to be paid. UNREAL! Haven’t seen this with any other plans even within Humana.
    Just wanted to share in case you’re peppered with similar questions.
    Ed Vezzola, PT