CIGNA Virtual Care Guidelines

  • In an effort to remove barriers for our customers to access timely and safe care, while ensuring that providers can continue to deliver necessary services in necessary settings, Cigna will allow providers to bill a standard face-to-face visit for all virtual care services, including those not related to COVID-19.
  • This means that providers can perform services for commercial Cigna customers in a virtual setting and bill as though the services were performed face-to-face.
  • Providers should bill using a face-to-face evaluation and management code, append the GQ modifier, and use the POS that would be typically billed if the service was delivered face to face.1
  • Providers will be reimbursed consistent with their typical face-to-face rates.
  • Providers can also bill code G2012 for a 5-10 minute phone conversation, and Cigna will waive cost-share for the customer. This will allow for quick telephonic consultations related to COVID-19 screening or other necessary consults, and will offer appropriate reimbursement to providers for this amount of time.

GQ modifier may be submitted with telehealth services. Generally, interactive audio and video communications must be used to permit real-time communication between the distant site physician/practitioner and the Medicare beneficiary.

Note CIGNA is indicating to use GQ and place of service would be office 11


Leave a Reply

Avatar placeholder