CommercialPrior AuthMedium impact
Update to prior authorization requirements for partial hospitalization level of care effective January 1, 2025
Cigna·Psychiatry·Prior Authorization
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Summary
Evernorth Behavioral Health has eliminated prior authorization requirements for partial hospitalization (PHP) level of care for most plans effective January 1, 2025. However, a small number of plans still require prior authorization, and Network Exception Requests continue to require prior authorization.
Action Required
Immediately: Billing team must verify prior authorization requirements for each PHP patient using Provider.Evernorth.com portal or by calling 800.926.2273 before rendering services, as requirements vary by plan. Update workflow to identify Cigna Connect IFP plans on patient ID cards. Use new PHP Network Exception Request Form available on Provider.Evernorth.com for network exception cases.