All PlansPrior AuthHigh impact
Updated resources for applied behavior analysis
Cigna·Psychiatry·Prior Authorization
Effective date
Jan 15, 2025
We identified it
Jun 19, 2026
Summary
Evernorth updated their Applied Behavior Analysis (ABA) prior authorization forms and coverage policy effective January 15, 2025. The prior authorization form has been condensed with clearer documentation requirements, and the coverage policy now includes specific timeframes for baseline data collection (within 60 days) and updated treatment criteria.
Action Required
Immediately: Download the updated Applied Behavior Analysis Prior Authorization Form from Provider.Evernorth.com when available in coming weeks. Update ABA authorization requests to include quantitative baseline data collected within 60 days prior to treatment start. For continued treatment requests, ensure current data is no more than 60 days old prior to continued treatment start date. Review the updated Intensive Behavioral Interventions coverage policy (EN0499) for new documentation requirements including individualized transition plans and autism spectrum diagnosis symptoms per DSM-5-TR.