Cigna Healthcare Mental Health Coverage Guide

Does Cigna Cover Therapy?

Yes, Cigna covers therapy. Cigna Healthcare, part of The Cigna Group, serves approximately 18 million medical members and provides comprehensive mental health coverage. Under the Mental Health Parity and Addiction Equity Act, Cigna is required to cover mental health services on par with medical and surgical benefits.

Cigna's behavioral health services are managed through Evernorth Behavioral Health, which maintains a network of over 300,000 behavioral health providers. This large network gives Cigna members broad access to therapists, psychiatrists, and other mental health professionals across the country.

If you are considering therapy for the first time, our therapy for beginners guide provides a helpful overview of the process.

Types of Therapy Covered by Cigna

Cigna covers a wide range of mental health services when provided by a licensed professional:

• Individual therapy — one-on-one sessions billed under CPT codes 90834 (45 minutes) or 90837 (60 minutes)
• Group therapy — sessions with multiple participants led by a licensed therapist (CPT 90853)
• Family therapy — sessions that include family members with a diagnosed individual present (CPT 90847)
• Psychiatric evaluation — initial diagnostic assessment (CPT 90791)
• Medication management — ongoing psychiatric sessions to monitor and adjust medications
• Substance use treatment — outpatient and intensive treatment for substance use disorders

Cigna covers evidence-based therapeutic approaches including cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), EMDR, acceptance and commitment therapy (ACT), and exposure and response prevention (ERP).

Treatment is covered for conditions such as anxiety, depression, PTSD, OCD, bipolar disorder, eating disorders, ADHD, trauma, and addiction.

In-Network vs. Out-of-Network Coverage

The choice between in-network and out-of-network therapists significantly affects your costs with Cigna.

In-Network Therapists

When you see a provider in Cigna's Evernorth Behavioral Health network:

• Predictable copays — typically $20 to $50 per session
• Reduced overall cost — Cigna's negotiated rates mean lower total charges
• No balance billing — in-network providers accept Cigna's approved rate as payment in full
• Seamless claims processing — your therapist files claims directly with Cigna

Out-of-Network Therapists

Many Cigna PPO and POS plans include out-of-network benefits:

• Higher deductible — separate out-of-network deductible, often $1,000 to $4,000
• Higher coinsurance — you may pay 30% to 50% of Cigna's allowed amount
• Balance billing — out-of-network therapists can bill above Cigna's allowed amount
• Upfront payment — you pay the full fee and submit a superbill for partial reimbursement

If you have a Cigna HMO plan, out-of-network coverage is generally not available except in emergencies or with special authorization.

For a comprehensive overview of therapy payment options, see our guide to paying for therapy.

How to Find In-Network Therapists

Cigna offers several tools to help you find a covered therapist:

1. Evernorth provider directory — Visit Cigna's provider directory and search for behavioral health providers by location, specialty, and availability. Enter your plan information for the most accurate results.

2. myCigna portal — Log into myCigna.com for personalized provider search results based on your specific plan and benefits.

3. myCigna app — Search for providers and verify benefits on the go with Cigna's mobile app.

4. Call member services — Contact Cigna at 1-800-244-6224 or the number on your insurance card for help finding in-network behavioral health providers.

5. Contact therapists directly — If you have a specific therapist in mind, call their office and ask whether they are in Cigna's network. Specify your exact plan name, as network participation can vary by plan.

For broader guidance on finding the right therapist, our guide on how to find a therapist covers key considerations beyond insurance.

Common Copays and Deductibles

Cigna therapy costs depend on your specific plan. Here are typical ranges:

Your actual costs depend on your plan type (HMO, PPO, EPO, POS, OAP, or HDHP), your employer's plan design, and how much of your deductible you have already met for the year.

Cigna also offers EAP programs through Evernorth, typically providing 3 to 8 free therapy sessions. These sessions are available at no cost and do not require you to meet a deductible. Check with your employer's HR department to see if EAP is included in your benefits.

Mental Health Parity Information

Federal parity law protects Cigna members' access to mental health care:

• Equal financial requirements — copays, deductibles, and coinsurance for therapy must be comparable to those for medical visits
• No discriminatory treatment limits — Cigna cannot impose session limits on mental health care that are stricter than limits on medical treatment
• Adequate network access — Cigna must maintain a behavioral health provider network sufficient to serve its members
• Consistent utilization management — any review processes for mental health treatment must be applied equally to medical care

Cigna has faced some scrutiny regarding parity compliance, particularly around network adequacy and out-of-network reimbursement rates. If you believe your mental health benefits are being applied unfairly, you can file a complaint with your state insurance department or the U.S. Department of Labor (for employer-sponsored plans).

If a claim is denied, request the specific reason in writing and file a formal appeal. Include a letter of medical necessity from your therapist to support your case.

Pre-Authorization Requirements

Cigna generally does not require prior authorization for routine outpatient therapy. You can typically begin treatment with an in-network therapist without seeking approval first.

Prior authorization is usually required for:

• Intensive outpatient programs (IOP)
• Partial hospitalization programs (PHP)
• Residential treatment facilities
• Inpatient psychiatric hospitalization
• Psychological and neuropsychological testing
• Applied behavioral analysis (ABA)

If your therapist recommends stepping up to a higher level of care, the authorization process is typically initiated by your treatment provider. For ongoing outpatient therapy, Cigna may conduct periodic utilization reviews, but this does not usually require you to take any action.

Telehealth and Online Therapy Coverage

Cigna covers telehealth therapy sessions for most plan members, enabling you to attend therapy via video or phone from any convenient location.

Key details about Cigna's telehealth coverage:

• Same cost-sharing — most Cigna plans apply the same copay or coinsurance to telehealth as in-person visits
• Evernorth digital tools — Cigna offers digital behavioral health resources through the Evernorth platform, including virtual therapy options
• Broad in-network access — many Cigna in-network therapists offer both in-person and telehealth appointments
• Licensing requirements — for telehealth, your therapist must be licensed in the state where you are physically located during the session

Cigna has invested significantly in virtual care infrastructure, making telehealth one of the more accessible options for Cigna members. Verify your specific plan's telehealth provisions by calling member services or checking the myCigna portal.

Tips for Maximizing Your Cigna Benefits

1. Use the myCigna app for benefits verification — Before scheduling your first appointment, log into myCigna to review your behavioral health benefits, including deductible status, copay amounts, and any coverage specifics.

2. Search the Evernorth network — Cigna's behavioral health network is large. Take time to search the directory thoroughly, filtering by specialty, location, and availability.

3. Start with EAP if available — Free EAP sessions through Evernorth are a valuable benefit. Use them first, then transition to your regular insurance coverage if you need ongoing therapy.

4. Stay in-network — The cost savings of seeing an in-network provider can be significant. If you cannot find a suitable in-network therapist, contact Cigna about a network gap exception, which may allow you to see an out-of-network provider at in-network rates.

5. Submit superbills through myCigna — For out-of-network care, submit superbills through the myCigna portal for the fastest processing. Include all required information: date of service, CPT code, ICD-10 diagnosis code, provider NPI, and amount charged.

6. Use HSA or FSA for therapy costs — Therapy copays and out-of-pocket costs are eligible expenses for Health Savings Accounts and Flexible Spending Accounts.

7. Know your plan type — Cigna offers HMO, PPO, EPO, POS, OAP, and HDHP plans, each with different rules. Understanding your plan type helps you avoid unexpected costs.

8. Appeal denied claims — If Cigna denies coverage, request the denial in writing, gather supporting documentation from your therapist, and file a formal appeal. Cigna typically processes out-of-network claims within 30 business days.

For additional strategies, read our guide on how to pay for therapy.

FAQ

Does Cigna require a referral for therapy?

Most Cigna PPO and POS plans do not require a referral to see a therapist. Cigna HMO plans may require a referral from your primary care physician before seeing a behavioral health specialist. Check your plan documents or call the number on your insurance card to confirm.

How many therapy sessions does Cigna cover?

Under federal parity law, Cigna cannot set annual session limits for mental health treatment that are more restrictive than limits on medical care. Most Cigna plans do not have a hard cap on outpatient therapy sessions. However, some plans may require periodic reviews for ongoing treatment. Confirm your plan's specifics with member services.

Does Cigna cover couples therapy?

Cigna covers family and couples therapy when one partner has a diagnosed mental health condition such as depression or anxiety and the therapy is billed under that individual. Relationship counseling without a clinical diagnosis is typically not covered. Discuss coding with your therapist.

What is Evernorth Behavioral Health?

Evernorth is Cigna's health services division that manages behavioral health benefits. They maintain the behavioral health provider network, handle claims for mental health services, and offer digital tools and resources for mental wellness. When you search for therapists or manage behavioral health claims, you may interact with Evernorth systems.

Does Cigna cover substance abuse treatment?

Yes, Cigna covers substance use disorder treatment as required by federal parity law. This includes outpatient counseling, intensive outpatient programs, partial hospitalization, residential treatment, and medication-assisted treatment (MAT). Prior authorization is typically required for anything beyond standard outpatient therapy. Learn more about addiction treatment.

How long does Cigna take to process out-of-network claims?

Cigna typically processes out-of-network claims within 30 business days of receiving a complete superbill. You can track claim status through the myCigna portal or mobile app. Ensure your superbill includes all required fields (provider NPI, tax ID, CPT code, ICD-10 code, date of service, and amount) to avoid processing delays.