Cigna and Evernorth Behavioral Health psychotherapy coverage: codes, telehealth and prior authorization
The short answerCigna's virtual care policy R31 lists 90785, 90791, 90832, 90834, 90837, 90846, 90847 and 90853 as eligible for virtual care under behavioral health plans. Bill POS 02 with modifier 93, 95, FQ, GQ or GT. Evernorth's guide shows no prior authorization for these outpatient codes but says to verify benefits.
By Javier Alvarez · Updated · 1 min read
1 row: Cigna / Evernorth Behavioral Health. Public policy, not the member's benefits.
Cigna and Evernorth Behavioral Health
Cigna Commercial Virtual Care policy R31 (behavioral health section) and Evernorth Behavioral Health prior authorization guide · All states
| 90785 | Listed (eligible for virtual care reimbursement under a Behavioral Health plan) [1] |
|---|---|
| 90791 | Listed (eligible for virtual care reimbursement under a Behavioral Health plan) [1] |
| 90832 | Listed (eligible for virtual care reimbursement under a Behavioral Health plan) [1] |
| 90834 | Listed (eligible for virtual care reimbursement under a Behavioral Health plan) [1] |
| 90837 | Listed (eligible for virtual care reimbursement under a Behavioral Health plan) [1] |
| 90846 | Listed (eligible for virtual care reimbursement under a Behavioral Health plan) [1] |
| 90847 | Listed (eligible for virtual care reimbursement under a Behavioral Health plan) [1] |
| 90853 | Listed (eligible for virtual care reimbursement under a Behavioral Health plan) [1] |
| Where it applies | Applies to CMS-1500 claims for Cigna Commercial plans and to CMS-1500 and UB-04 claims for Behavioral Health administered plans. Virtual care must be provided by a professional who is licensed or acting within licensure. [1] |
| Telehealth POS | Report place of service 02 for behavioral health virtual care. [1] |
| Telehealth modifier | Append modifier 93, 95, FQ, GQ or GT. The permanent record must show whether the visit was audio/video or telephone only. [1] |
| Telehealth rules | Behavioral health virtual care must be interactive audio and/or video (synchronous) and is reimbursed as if provided face-to-face. Exclusively virtual services should be limited to low to moderate complexity and not be the primary intervention for an emergent condition. Not reimbursed on the same day as a face-to-face visit by the same provider for the same condition. The policy does not apply to care through an intermediary vendor or when a superseding state mandate applies. [1] |
| Prior authorization | The Evernorth guide (03/26) shows prior authorization 'No' for 90785, 90791, 90792, 90832, 90834, 90837, 90839, 90846, 90847 and 90853, billed on a CMS 1500 (UB only if outpatient). It says the list is not complete and subject to change, the codes are only suggestions, and to verify eligibility and benefits. [2] |
- Cigna: Reimbursement Policy R31 Virtual Care, Commercial (last updated 02/17/2026), checked October 30, 2026
- Evernorth Behavioral Health: Resource Guide, Prior Authorizations and Billing (PCOMM-2026-168, 03/26), checked October 30, 2026
What Cigna and Evernorth Behavioral Health's documents say
The table above has every field we found for Cigna and Evernorth Behavioral Health, with numbered sources. In short:
- Prior authorization. The Evernorth guide (03/26) shows prior authorization 'No' for 90785, 90791, 90792, 90832, 90834, 90837, 90839, 90846, 90847 and 90853, billed on a CMS 1500 (UB only if outpatient). It says the list is not complete and subject to change, the codes are only suggestions, and to verify eligibility and benefits.
- Telehealth rules. Behavioral health virtual care must be interactive audio and/or video (synchronous) and is reimbursed as if provided face-to-face. Exclusively virtual services should be limited to low to moderate complexity and not be the primary intervention for an emergent condition. Not reimbursed on the same day as a face-to-face visit by the same provider for the same condition. The policy does not apply to care through an intermediary vendor or when a superseding state mandate applies.
- Telehealth POS. Report place of service 02 for behavioral health virtual care.
- Codes. 90785, 90791, 90832, 90834, 90837, 90846, 90847 and 90853 are listed.
Psychotherapy coverage at other national payers
Medicare, TRICARE and UnitedHealthcare and Optum Behavioral Health.
Check Cigna and Evernorth Behavioral Health's claim against the row
Before the claim goes out, compare it with the row above: the code matches the session length you documented, the place of service and modifier fit a video or audio-only visit, and the rendering clinician's license is one the payer enrolls. The psychotherapy table compares Cigna / Evernorth Behavioral Health with every other payer we checked.