Cigna / Evernorth

Commercial

ABA billing requirements · Source: Cigna/Evernorth Clinical Payment & Coding Policy — ABA

High confidence

Verified 2026-03-01

Authorization Requirements

Requires prior auth Yes

Initial auth duration6 months

Renewal auth duration6 months

Submission deadline30 days

Unit tracking cadenceTotal

Requires FBA Yes

Diagnostic eval validity36 months

Re-eval cadenceEvery 12 months

BH carve-out managereviCore

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsDiagnosis, Baseline data, Goals and objectives, Methodology, Supervision plan

Progress summary cadenceEvery 6 months

Behavioral health managed through Evernorth. Requires BCBA-level supervision. Auth requests via Availity portal.

CPT rules require a free account

View H-codes, modifiers, unit limits, and billing restrictions for Cigna / Evernorth.

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Data last verified: 2026-03-01 · Confidence: High · See our methodology