Cigna and Evernorth Behavioral Health: Credentialing and Billing for Mental Health Providers

Cigna Healthcare’s behavioral health benefits are managed through Evernorth Behavioral Health, part of The Cigna Group. To see Cigna members in-network for mental health, therapists and psychiatric providers join that behavioral network: keep CAQH ProView complete and shared, request participation through Cigna’s provider channels, sign the agreement and wait for an effective date. EAP visits are a separate benefit with their own rules.

Cigna is a large commercial insurer, especially for employer plans, so many therapy and psychiatry practices see a steady share of Cigna members. The behavioral network and its rules are separate from Cigna’s medical side.

Cigna products to tell apart

Product	What it is	What to check
Cigna Healthcare commercial	Employer and individual plans	Behavioral network participation through Evernorth
Employer plans administered by Cigna	Self-funded employers using Cigna’s network	Benefits vary by employer; verify each patient
Cigna EAP	Short-term counseling through an employee assistance program	Separate authorization, session limit and billing process
Other Cigna Group programs	Varies	Check the member’s ID card for the behavioral health contact

Credentialing with Cigna / Evernorth

1. Prepare the basics: license, individual NPI with correct taxonomy, malpractice coverage, and group NPI if billing as a group.
2. CAQH ProView: complete, attest and authorize Cigna to view it.
3. Request to join the behavioral health network through Cigna’s provider website. If the network is closed, request an exception based on the need you fill.
4. Complete credentialing and sign the agreement.
5. Confirm your effective date, then set up electronic claims, ERA and EFT.

See how to get paneled with insurance for the full process and timeline.

Billing notes for Cigna

• EAP or regular benefit? Ask at intake. EAP sessions usually need an authorization number, have a set number of free sessions, and are billed under EAP instructions. When EAP sessions run out, the patient may continue under their regular benefit with normal cost sharing.
• Verify benefits for each patient: copay or coinsurance, deductible, and authorization needs for higher levels of care.
• Telehealth: follow Cigna’s current telehealth policy for place of service and modifiers (see our telehealth billing guide).
• Document psychotherapy time for every session (see 90837 vs 90834).
• Prescribers: E/M visits with psychotherapy add-ons need separately documented therapy time (see billing 99214 with 90833).

Common Cigna denials

Denial	Usual cause	Fix
Authorization missing	EAP session billed without the EAP authorization, or a service needing pre-approval	Get the authorization; bill under the right benefit
Out of network	Clinician not in the behavioral network, or not yet effective	Confirm participation and effective date
Benefit maximum reached	EAP sessions used up	Move the patient to the regular benefit if covered
Missing or invalid information	Subscriber, NPI or taxonomy mismatch	Correct and resubmit

See denial codes explained for how to read the remittance.

We are an independent billing and credentialing company, not affiliated with Cigna or Evernorth. Payer processes and program names change, so confirm current requirements on Cigna’s provider site. Our mental health credentialing team handles Cigna applications and follow-up, with weekly status updates.

Frequently asked questions