Cigna Healthcare^® works with EviCore by Evernorth® (EviCore) to administer precertification programs for Cigna Healthcare customers. Effective March 7, 2026, Experimental/Investigation/Unproven (EIU), Outpatient Surgery, Unlisted Procedures, and Cosmetic procedure codes will be managed by EviCore. This update applies to Cigna Healthcare U.S. commercial medical plans, Individual & Family Plans, and International Health plans (North America).

Precertification

Precertification is not required for services performed:

• In an emergency room
• During a 23-hour observation

How to request precertification

The preferred and most efficient method for submitting precertification requests is through EviCore’s website. While we encourage providers to submit requests through the website, providers may also request precertification by calling EviCore at 866.668.9250 (7 am-7 pm).
It is the responsibility of the provider to obtain precertifications. Precertification requests must include the following information:

• Patient’s name, date of birth, and patient identification number from their ID card
• Ordering provider’s name, National Provider Identifier (NPI), tax identification number (TIN), and address
• Rendering facility’s name, NPI, TIN, and address
• Supporting clinical information

CPT codes

A full list of Current Procedural Terminology (CPT^®) codes associated with the affected procedures, as well as additional information about the services, is available at CIGNA Commercial CPT Code List - Comprehensive_pub01.15.2026.pdf

Important notes

Please keep in mind the following:

• It is the responsibility of the rendering facility and provider to confirm precertification has been requested and approved prior to the service(s) being performed. Verification may be obtained via EviCore.com or by calling 866.668.9250.
• Decisions for non-urgent precertification requests are typically made within two business days of receipt of all necessary clinical information. All decisions are made within five business days.

Obtaining a medical necessity approval from EviCore isn't a guarantee that Cigna Healthcare will pay for services rendered. The customer must be enrolled in the plan and eligible for benefits on the date they receive the service. Please see plan documents for details about coverage.