CommercialPrior AuthLow impact
Annual review of behavioral health medical necessity criteria
Cigna·Psychiatry, Family Medicine, Internal Medicine +1 more·Prior Authorization
Effective date
Mar 1, 2026
We identified it
Jun 18, 2026
Summary
Evernorth has completed their annual review of behavioral health medical necessity criteria with no major changes identified. The existing criteria remain in effect, including MCG Behavioral Health Guidelines 30th edition, ASAM Criteria, and state-specific requirements.
Action Required
No immediate action required. Continue using current behavioral health prior authorization processes and medical necessity criteria. Billing team should reference the Evernorth Behavioral Health Prior Authorization and Billing Resource Guide for ongoing requirements.