Site of Service Payment Change

Beginning January 1, 2017, CIgna will be adjusting certain fee schedules, and updating the Cigna Administrative Guidelines on how physicians will be reimbursed, for certain services based on where the service is performed. This methodology, typically referred to as “site of service” reimbursement, will apply to approximately 1,900 CPT codes for services that have a site of service designation, as established by CMS. Beginning January 1, 2017, reimbursement for certain covered physician services that are performed in a location other than a physician’s office will be calculated based on the facility RVU. For covered services performed in the office, reimbursement will be calculated based on the non-facility (office) RVU. Affected providers may experience a change in reimbursement for covered services based on the location where the service was performed. A full listing of the codes that have site of service designation can be found at Resources > Latest News> Medical.