Effective April 11, 2016, Cigna will update their Ambulance Services Reimbursement Policy (R18) and only reimburse non-emergency ambulance transportation when a hospital is the origin or destination of the service. Claims billed without a hospital modifier (H) will be administratively denied.
Cigna will also not provide additional reimbursement for ancillary services during non-emergency ambulance transportation, such as intravenous therapy (IV), oxygen, pulse oximetry, ambulance waiting time, and mileage past the nearest hospital.
Cigna is updating the policy so that claims for non-emergency ambulance services are processed consistently across all claim platforms, and are aligned with industry standards and benefit plan language. This policy update will affect participating and non-participating ambulance companies. Air and emergency ambulance transportation or services are not affected by this update.