--- title: "Cigna / Evernorth ABA coverage in Tennessee: the intake guide." url: "https://carelu.com/payers/cigna-tennessee" markdown_url: "https://carelu.com/payers/cigna-tennessee.md" state: TN (Tennessee) payer: Cigna / Evernorth in Tennessee kind: Commercial insurance description: "How Cigna / Evernorth covers ABA for Tennessee families — the national clinical policy, prior authorization, the Tenn. Code Ann. § 56-7-2367 mandate (ages, caps, exemptions), Tennessee behavior-analyst licensure, and what intake should verify." last_reviewed: October 2026 vob_data_updated: 2026-10-15 --- # Cigna / Evernorth ABA coverage in Tennessee: the intake guide. _Payer Guide · Cigna · Tennessee · Last updated October 2026 · 6 primary sources_ > EN0499 + autism resource guide + the Tenn. Code Ann. § 56-7-2367 mandate layer. For an intake team in Tennessee, a Cigna card means three layers at once: the carrier's national clinical policy, Tennessee's autism insurance mandate (Tenn. Code Ann. § 56-7-2367), and the plan's funding type deciding which of the two actually binds. This guide stacks them in order. ## Prior authorization and diagnosis at a glance - **Prior auth for the assessment**: Not required for assessment codes 97151, 97152, 0362T (per Cigna's autism resource guide — EN0499 itself states no prior-authorization rule) [1] - **Prior auth for treatment**: Required — assessment + treatment plan with the ABA PA form (see Cigna's autism resource guide; EN0499 sets the clinical criteria, not the PA rule) [1] - **Autism diagnosis required?**: Yes — ASD only; Rett syndrome (F84.2) excluded under EN0499 [1] ## At a glance - **Covers ABA?:** Yes — for ASD, per the national Cigna policy - **State mandate:** Tenn. Code Ann. § 56-7-2367 - **Mandate age:** Statute keyed to under-12 (parity-style, not an ABA mandate) - **Mandate caps:** No ABA-specific benefit — carrier policy governs - **Exempt from mandate:** Plans without neurological-disorder benefits; self-funded ERISA - **Licensure:** TN Licensed Behavior Analyst (Dept. of Health committee) - **Fee schedule:** Not public — your rates and the list of reimbursable ASD services are in Exhibit A of your Evernorth provider agreement ## The national policy, applied in Tennessee Cigna (through Evernorth Behavioral Health) covers ABA for autism under national policy EN0499 with one of the friendliest front doors in the industry: no prior authorization on assessment codes 97151, 97152, and 0362T. The rigor arrives at the treatment step, which requires the completed assessment plus a treatment plan with Cigna's ABA PA form. That clinical policy is national — what changes in Tennessee is the legal floor underneath it: the state mandate below governs what fully-insured plans must cover, while self-funded employer plans answer to ERISA and federal parity instead. Plan funding type is therefore the first fact to establish on every benefits check. The full national policy breakdown lives in our Cigna / Evernorth guide; this page covers what changes in Tennessee. [1][2] ## The Tennessee mandate: what it guarantees (and doesn't) Tennessee’s statute is the weakest of the states we cover — it’s a parity rule, not an ABA mandate. For insureds under 12, plans that cover neurological disorders must provide ASD benefits at least as comprehensive, with cost-sharing no more stringent; ABA is never named, and the statute explicitly doesn’t expand the type or scope of treatment beyond other neurological disorders. In practice, commercial ABA coverage in Tennessee rides on the carrier’s national medical policy and the plan document — which makes benefits verification, not the mandate, the load-bearing step. Self-funded ERISA plans are exempt where federal law preempts, and MHPAEA supplies the stronger parity floor for group plans. [3] ## No Tennessee-specific Cigna policy exists We checked: Cigna / Evernorth publishes no Tennessee-specific ABA policy, form, or supplement — the national policy plus the state mandate is the whole picture. That’s worth knowing in itself: it means benefits verification (plan funding type, mandate applicability, benefit limits) is where Tennessee-specific answers come from, not a carrier document. [1] ## Licensure & rates in Tennessee Tennessee requires the Licensed Behavior Analyst (LBA) credential under Tenn. Code Ann. §§ 63-11-301 through 63-11-311, administered by the Applied Behavior Analyst Licensing Committee at the Department of Health — the same licensure gate that governs TennCare work applies on the commercial side. On rates: Cigna does not publish commercial ABA fee schedules for Tennessee (none of the national carriers do) — rates are contract-negotiated and live in your participating-provider agreement, so treat rate expectations as a contracting conversation, not a lookup. [4] ## What is Cigna's fee schedule for ABA? Cigna's behavioral health arm, Evernorth, publishes no ABA rate table. Its September 2026 Administrative Guidelines tell contracted providers: "For your fee schedule and a listing of autism spectrum disorder–related services eligible for reimbursement, refer to Exhibit A in your Provider Agreement." Fee schedule and contract questions go to Evernorth Provider Services at 800.926.2273. [5][2] Billing follows the AMA codes only: "All ABA services must be billed with CPT codes 97151–97158, 0362T, and 0373T ONLY," in 15-minute units, under Evernorth payer ID 62308. [5][2] ## Is Cigna's ABA network open to new providers? Evernorth says it "is committed to expanding our network of autism providers." Providers must be certified by a national governing agency or a state licensing board (BCBA, BCBA-D, BCaBA, licensed behavior analyst, licensed behavior specialist or other behavioral health licensure). Individual providers complete the Evernorth Behavioral Provider Information Form; autism clinics and large groups complete the Evernorth Screening Application for Autism Clinics. [2] Timing: "It may take up to 90 days for an application to be processed," and after a clinic contract is signed each certified or licensed provider must be credentialed, which "can take an additional 60 to 90 days." Providers must be fully credentialed to render in-network services. Questions go to BehavioralContracting@Evernorth.com or Provider Services at 800.926.2273. [2] ## How fast must Cigna pay an ABA claim in Tennessee? Filing deadline: Evernorth, which runs Cigna's behavioral network, “will only consider claims submitted within 90 days of the date of service or as otherwise defined in your Provider Agreement,” unless state law allows longer. For a COB claim the 90 days run “based on the primary payer's processing date as stated on an explanation of benefits [EOB] or explanation of payment [EOP],” and a timely claim returned for more information gets a new 90 days from the date of the request. A correction goes in as a replacement or void claim (CMS-1500 field 22 with frequency code 7 or 8); do not stamp it “Corrected Claim.” Codes: “All ABA services must be billed with CPT codes 97151–97158, 0362T, and 0373T ONLY,” so H-codes such as H0031 or H0032 are not used for ABA. Tennessee addendum (insured plans; it does not apply to self-funded plans): the provider “shall file a claim for reimbursement for a health care service within one hundred twenty (120) days of the date of service,” and a claim filed later may be denied in full; a request to correct a payment error filed more than 15 months after payment need not be honored (Tenn. Code Ann. 56-7-110). Appeals: “all appeals are to be initiated in writing within 180 calendar days of the date of the initial payment or denial decision,” and a second-level appeal is due within 60 days of the first-level decision letter. The guidelines publish no check-run day or weekly submission cutoff. [5][2][6] Payment clock: Tennessee’s prompt-pay law (Tenn. Code Ann. 56-7-109) gives a health insurance entity 21 calendar days for a claim submitted electronically and 30 calendar days for a paper claim to pay a clean claim, pay the undisputed part, or say what is missing, with 1% interest a month on late amounts. A claim submitted more than 90 days after the date of service is not a “clean claim” under the statute, so file early. A self-funded employer plan may sit outside Tennessee insurance law, so confirm the funding type first. [5][2][6] ## What an ABA reauthorization request must contain (and whether graphs are required) Cigna (Evernorth EN0499) asks for dated quantitative data rather than graphs. Continued treatment needs an updated treatment plan, “quantitative baseline, interim and current data … with dates reported from when the data were collected” for every behavior and skill targeted across settings, current data “collected within no more than 60 days prior to the start date of the continued treatment request, as well as collected within no more than 60 days prior to the date the authorization request is received,” evidence of “ongoing and sustained progress,” and improvement shown on “a reliable, valid, and standardized assessment instrument completed no more than one year prior to the start date of the continued treatment request.” The policy does not require the data to be graphed. [1] ## Intake gates The questions that decide whether a family can start with Cigna / Evernorth in Tennessee, and what they have to bring. - **Diagnosis recency**: EN0499 puts its clocks on the assessment and the data, not on the diagnosis. The diagnosis must be confirmed with “the date on which the diagnosis was most recently made” documented, but carries no maximum age. What must be current is the instrument and the data: “administration of the assessment instrument has been completed within 60 days prior to the start of treatment,” quantitative baseline data likewise within 60 days, current data within 60 days of both the start date and the date the request is received, and a fresh standardized instrument “following any break in treatment greater than 60 calendar days.” Continued treatment needs an instrument “completed no more than one year prior to the start date of the continued treatment request.” [1] - **Who may diagnose**: “The individual has a confirmed diagnosis of autism spectrum disorder (ASD)… based on the criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) by a healthcare professional who is licensed to practice independently and whose licensure board considers diagnostics to be within their scope of practice,” with the name, credentials and type of licensure of the diagnostician and the date of the most recent diagnosis all provided. The ABA assessment is separate and must be performed by a BCBA, LBA, or an independently licensed mental health clinician with documented ABA training. Note the diagnosis must be ASD (F84.0–F84.9): Rett syndrome (F84.2) is excluded. [1] - **Diagnostic tools required**: No instrument is named, but the specification is strict. The assessment must administer “a reliable, valid, and standardized assessment instrument that measures the individual’s functioning in the domains included in the diagnostic criteria for ASD in the DSM-5-TR… social communication and social interaction; and restricted, repetitive patterns of behavior, interests, or activities,” and the instrument must be “completed in its entirety and as designed,” validated for the population tested, administered and interpreted by someone trained to do so, and “the most current version… (e.g., must be the Vineland-3 vs. Vineland-II).” Standardized scores, score tables and scoring grids must be provided, with the date of administration, respondent name and form type. [1] - **Referral required?**: EN0499 requires no referral or physician order — the gate is the confirmed diagnosis plus the ABA assessment. Assessment codes 97151, 97152 and 0362T carry no prior authorization at all; the rigor arrives at the treatment step, which needs the completed assessment and a treatment plan submitted on Cigna’s ABA PA form. Tennessee adds nothing here: § 56-7-2367 imposes no ordering requirement and Cigna publishes no Tennessee-specific ABA supplement. [1][3] - **Telehealth**: Permitted. EN0499 itself publishes no code list and no place-of-service rule: “ABA treatment may be rendered via traditional in-person service delivery, telehealth, or a hybrid of in-person and telehealth service modalities,” chosen on individual characteristics, treatment plan, caregiver participation, environment, evidence of efficacy and safety, and technological requirements. Telehealth is one of the environments where the policy requires services to be “clearly identified and documented,” and the line-of-sight/proximity requirement expressly “does not apply to telehealth services, when applicable.” Evernorth’s autism resource guide (March 2025) settles the code question: "All ABA CPT codes are covered telehealth services." That includes the assessment codes 97151 and 97152 and BCBA supervision (97155). On the claim, Evernorth's Administrative Guidelines (September 2026) say that when billing telehealth services providers should use “Modifier 95 in Field 24-D to specify telehealth” and “02 for Place of Service in Field 24-B.” They name no separate POS 10 rule, and say nothing about flagging telehealth on the authorization. [5][1][2] - **Age limit** _(plan-dependent)_: EN0499 states no age limit — the policy gates on diagnosis, assessment and data rather than age. Tennessee’s mandate does not add one usefully either: § 56-7-2367 is a parity rule keyed to insureds under 12 that never names ABA, so an age answer on a Tennessee Cigna card comes from the benefit document rather than from the policy or the statute. [1][3] - Ask the plan: Live benefits verification on the specific plan; the summary plan description for a self-funded employer group. - **Prior-auth decision time** _(plan-dependent)_: It depends on how the plan is funded. A fully insured Cigna plan sold in Tennessee follows the Prior Authorization Fairness Act. A standard request is "deemed approved within seven (7) calendar days" of submission if the carrier fails to approve, deny, or ask for the missing information. If it asks, it gets "an additional five (5) calendar days" after the provider responds, and the whole process "must not exceed seventeen (17) calendar days." An urgent request is deemed approved if not decided within "seventy-two (72) hours plus, if applicable, one (1) additional business day." A self-funded employer plan is governed by ERISA instead: pre-service decisions "not later than 15 days after receipt of the claim," with one 15-day extension, and urgent care "not later than 72 hours." No reauthorization lead time is published for Cigna ABA in Tennessee. [7][8] - Ask the plan: Benefits verification with Cigna: ask whether the plan is fully insured (Tennessee Prior Authorization Fairness Act) or self-funded (ERISA timelines), and the plan's reauthorization lead time. - **Other insurance (who pays first)** _(plan-dependent)_: Between two parents' group plans, Tennessee's coordination-of-benefits rule uses the birthday rule: "the benefits of the Plan of the parent whose birthday falls earlier in a year are determined before those of the Plan of the parent whose birthday falls later in that year." Only month and day count. If the birthdays match, the plan that has covered the parent longer pays first. A court decree or the divorced/separated-parent rules can change this. That rule governs fully insured group contracts. A self-funded employer plan sets its own order in its plan document, and individual policies are outside the group rule. The Cigna plan pays before TennCare, because Medicaid is payer of last resort. It also pays before TRICARE, which pays only after other coverage. When the child also has CHAMPVA, the Cigna plan pays first: "If you have any other type of other health insurance, CHAMPVA will pay secondary." Get the Cigna prior authorization even when a secondary plan will pick up the balance. [9][10][11][12] - Ask the plan: Cigna member services / benefits verification: confirm funding type and the COB order in the plan document, and collect the other parent's plan and each parent's date of birth at intake. ## Delivery and billing rules Coverage decides whether Cigna / Evernorth in Tennessee pays. These decide whether the claim survives: staffing and supervision, concurrent billing, per-day ceilings, who signs the note, where the service is payable, and whose NPI the claim goes out under. - **Supervision**: “Direct case supervision (occurs concurrently with the delivery of direct treatment to the individual and consists of BCBA face-to-face with the individual and either the Registered Behavior Technician [RBT] or the Board Certified Assistant Behavior Analyst [BCaBA]) and indirect case supervision is consistent with the general accepted standard of care of one to two hours per ten hours of direct treatment,” and “when direct treatment is 10 hours per week or less, a minimum of one to two hours per week of direct case supervision is provided.” The supervisor must be a BCBA, LBA, or an independently licensed mental health professional with documented ABA training, and “the name and credentials of the individual who will provide supervision must be documented.” In Tennessee that person must also hold the state LBA license to deliver direct ABA. [1][4] - **Daily limits / MUEs**: No per-day unit ceiling and no hour maximum. EN0499 is explicit that intensity is individually determined: “the recommended intensity of treatment should be based on what is medically necessary for the individual independent of the individual’s schedule of activities outside of treatment or previous utilization of services,” defined as direct ABA hours per week excluding case supervision and caregiver training. An increase request must carry a clinical rationale plus quantitative data showing how the added intensity would improve outcome. Any numeric ceiling a Tennessee family meets is a plan-document term, not a policy limit. [1] - **Session-note signature**: The rendering provider signs, per service. “A separate written record is expected for each individual receiving ABA intervention corresponding with each service noted through identified CPT Code” and must include the start date and time and end date and time for each service, location of service delivery, focus of service, a detailed description of the intervention, individuals present, the specific service delivered, and “name, credential (if applicable), and signature of ABA provider who rendered the service.” No supervising-analyst co-signature is required. [1] - **Place of service**: Setting follows clinical need rather than a payable-locations list: “care must be deliverable in any setting that is relevant for the individual to achieve treatment goals — whether in the home, at school, in a clinic or center, or in the community,” with residential treatment facilities, childcare facilities, transportation, vocational or educational classes and recreational and social environments all named. Two guardrails apply: “services that are considered primarily educational or vocational in nature, or related to academic or work performance are not covered or reimbursable,” and ABA may not “replace or replicate activities that are the responsibility of the setting… (e.g., classroom aide, 1:1 teacher, tutor, vocational assistant/coach, respite services).” Data must be reported separately by location when treatment spans settings. [1] - **Concurrent billing (97153 + 97155)** _(ask the plan)_: Not answered for 97153 with 97155. EN0499 defines concurrent billing only in its glossary — “regardless of the funding source, multiple providers bill for services rendered to the same patient when those services occur at the same time” — and the rule it actually states is about modalities: “provision of ABA treatment is not covered or reimbursable when delivered to the same individual, at the same time as any other treatment modality (e.g., ABA and speech therapy, or ABA and occupational therapy).” The 97155 descriptor Cigna reproduces already contemplates “simultaneous direction of technician,” but whether both codes may be billed for the same clock time is not addressed. [1] - Ask the plan: Cigna/Evernorth provider services and the applicable reimbursement (not coverage) policy; confirm in writing before billing the overlap. - **Bill as provider** _(ask the plan)_: EN0499 sets no rendering-versus-supervising NPI convention — it governs who may perform each service (BCBA/LBA/independently licensed clinician for assessment, supervision and caregiver training; technician for 97152/97153/97154 under direction) and requires the signature of whoever rendered it, but not whose number the claim carries. In Tennessee the delivery credential is the binding constraint: direct ABA requires a Licensed Behavior Analyst under T.C.A. §§ 63-11-301–311. Rates are contract-negotiated; Cigna publishes no Tennessee ABA fee schedule. [1][4] - Ask the plan: Cigna/Evernorth provider services and your participating-provider agreement for claim-submission conventions. ## What intake should collect for Cigna / Evernorth in Tennessee - **Plan funding type:** Fully insured (mandate applies) vs. self-funded ERISA (exempt) — it decides which rulebook governs. Ask for the employer and check the card. - **Member ID + card photo:** Enough to run a live benefits verification — the only reliable answer on limits and cost-sharing. - **Diagnosis report:** DSM-5 ASD diagnosis, diagnosing provider and credentials, evaluation date. - **Age:** Where the mandate carries age terms, flag edge cases for the parity analysis rather than turning families away. Free verification-call checklist (PDF): https://carelu.com/downloads/aba-verification-call-checklist.pdf ## Verification of benefits (VOB) data How Cigna / Evernorth in Tennessee ABA benefits route and read on an eligibility check. Data last updated 2026-10-15. ### EDI routing - **Payer ID (pVerify):** 00004 - **Payer ID (Availity):** 62308 - **Payer ID (Change Healthcare / Optum):** 62308 - **Supports 270/271 eligibility:** Yes - **Behavioral health administrator:** Evernorth Behavioral Health - **BH administrator payer ID:** 62308 - **ABA rides on:** medical benefit - **Two-hop verification required:** No ### How the 271 reports ABA benefits - **ABA benefit bucket (service type code):** MH - **Deductible applies to ABA:** yes — Base deductible for MH-flavored codes is returned per the companion guide's own worked example, but REMAINING deductible/benefit amounts are explicitly withheld for Mental Health, Pharmacy, and Vision plans (§7.2.2-7.2.3) — a real 271 for an ABA member may show the base figure but not how much has been used. - **Cost-share type:** plan-dependent — Both copay (EB*C) and coinsurance (EB*A) segments are structurally supported per plan; which applies to a given member is plan-document-specific. - **271 response quality for ABA:** high ### Code-level coverage | Code | Covered | Prior auth | Unit cap | Place of service | Telehealth | Modifiers | | --- | --- | --- | --- | --- | --- | --- | | 97151 | Yes | Not required (per EN0499) | — | — | — | — | | 97152 | Yes | Not required (per EN0499) | — | — | — | — | | 97153 | Yes | Required — assessment + treatment plan with the ABA PA form (EN0499) | — | — | — | — | | 97154 | Yes | Required — assessment + treatment plan with the ABA PA form (EN0499) | — | — | — | — | | 97155 | Yes | Required — assessment + treatment plan with the ABA PA form (EN0499) | — | — | — | — | | 97156 | Yes | Required — assessment + treatment plan with the ABA PA form (EN0499) | — | — | — | — | | 97157 | Yes | Required — assessment + treatment plan with the ABA PA form (EN0499) | — | — | — | — | | 97158 | Yes | Required — assessment + treatment plan with the ABA PA form (EN0499) | — | — | — | — | | 0362T | Yes | Not required (per EN0499) | — | — | — | — | | 0373T | Yes | Required — assessment + treatment plan with the ABA PA form (EN0499) | — | — | — | — | Code notes: - **97151, 97152, 97153, 97154, 97155, 97156, 97157, 97158, 0362T, 0373T:** Verify via: Cigna/Evernorth provider services — EN0499 is a medical-necessity policy only; no coding/reimbursement mechanics are published in it. ### Contacts - **Benefits by phone:** Yes - **Provider services phone:** 800.926.2273 — Cigna/Evernorth Provider Services, per Evernorth's own Behavioral Administrative Guidelines (used for eligibility/coverage verification, claim status, and "request precertification for services") - **Portal:** [Provider.Evernorth.com / CignaforHCP.com](https://provider.evernorth.com) Questions to ask on a verification call: - Is there a numeric unit or hour cap for ABA codes, and what is the authorization period? - What place-of-service codes and modifiers should be used when billing 97151-97158 and 0362T/0373T? - Is telehealth allowed for any ABA codes under this plan? ### VOB data sources - https://static.cigna.com/assets/chcp/pdf/coveragePolicies/medical/en_mm_0499_coveragepositioncriteria_intensive_behavioral_interventions.pdf (accessed 2026-07-23) - https://static.cigna.com/assets/chcp/pdf/coveragePolicies/medical/autism-resource-guide.pdf (accessed 2026-07-23) - https://pverify.com/wp-content/uploads/2026/03/pVerifyPayers_All-Payers-List-3-2026.pdf (accessed 2026-07-23) - https://essentials.availity.com/availity/documents/payer_list_wShortNames.pdf (accessed 2026-07-23; source document older than 18 months) - https://www.caqh.org/sites/default/files/CAQH%20CORE%20Eligibility%20Benefits%20(270_271)%20Data%20Content%20Rule%20vEB2.0.pdf (accessed 2026-07-23) - https://www.cigna.com/static/www-cigna-com/docs/5010-270-271-companion-guide.pdf (accessed 2026-07-23) - https://static.cigna.com/assets/chcp/pdf/resourceLibrary/behavioral/ebh-provider-admin-guide.pdf (accessed 2026-07-23; source document older than 18 months) ## Common questions ### What telehealth modifier and place of service does Cigna want on ABA claims? Evernorth, which administers Cigna's behavioral benefits, tells providers to bill telehealth with modifier 95 in field 24-D and place of service 02 in field 24-B. Its autism resource guide says all ABA CPT codes are covered telehealth services, subject to the Intensive Behavioral Interventions policy. ### Does Cigna require graphs for ABA reassessments? No graph requirement is published. Cigna's policy EN0499 requires dated baseline, interim and current data for every target, current data collected within 60 days of the request and of the requested start date, and a standardized assessment no more than one year old. ### What is Cigna's timely filing limit for ABA claims in Tennessee? For insured Tennessee plans, Evernorth's Tennessee addendum requires claims within 120 days of the date of service; elsewhere its standard is 90 days unless your agreement or state law sets longer. Self-funded plans are outside the addendum, so check the funding type. ### Does Cigna accept H0031 or H0032 for ABA in Tennessee? No. Cigna's autism resource guide says all ABA services must be billed with CPT 97151–97158, 0362T and 0373T only. ### How long do I have to appeal a Cigna ABA claim decision in Tennessee? 180 calendar days from the initial payment or denial decision, in writing, with a second-level appeal within 60 days of the first-level decision. ### Does Cigna cover ABA therapy in Tennessee? Yes — under the carrier's national policy for ASD, layered on Tennessee's mandate (Tenn. Code Ann. § 56-7-2367) for fully-insured plans. Self-funded employer plans are exempt from the mandate, so always verify plan funding type first. ### What does the Tennessee autism mandate require? Tennessee’s statute is the weakest of the states we cover — it’s a parity rule, not an ABA mandate. See the mandate section above for ages, caps, and exemptions — and remember federal parity limits how hard the numeric caps can be enforced against group plans. ### What does Cigna pay for ABA in Tennessee? Evernorth (Cigna behavioral health) publishes no ABA rate table. Its administrative guidelines say your fee schedule and the list of reimbursable autism services are in Exhibit A of your Evernorth provider agreement; call Provider Services at 800.926.2273 with fee schedule questions. ### Is Cigna (Evernorth) accepting new ABA providers? Evernorth says it is "committed to expanding our network of autism providers." Individuals file the Behavioral Provider Information Form and clinics the Screening Application for Autism Clinics; processing can take up to 90 days, plus 60 to 90 days of credentialing per provider after a clinic contract. ### Does Cigna require RBT certification for ABA technicians? Evernorth's autism resource guide does not name a technician credential. It says Evernorth "does not credential nonlicensed/noncertified staff" and that their services "must be billed under the supervising provider." Case supervision must come from a BCBA, LBA or independently licensed clinician with ABA training. State licensure rules can add requirements. ### How fast must Cigna pay an ABA claim in Tennessee? On a plan subject to Tennessee law, 21 calendar days for an electronic claim and 30 for a paper one, with 1% monthly interest on late payments; a claim filed more than 90 days after the date of service is not a clean claim under the statute (Tenn. Code Ann. 56-7-109). ## Primary sources 1. [Evernorth EN0499 — Intensive Behavioral Interventions](https://static.cigna.com/assets/chcp/pdf/coveragePolicies/medical/en_mm_0499_coveragepositioncriteria_intensive_behavioral_interventions.pdf) 2. [Cigna autism resource guide (Mar 2025)](https://static.cigna.com/assets/chcp/pdf/coveragePolicies/medical/autism-resource-guide.pdf) 3. [Tenn. Code Ann. § 56-7-2367 (autism/neurological parity)](https://codes.findlaw.com/tn/title-56-insurance/tn-code-sect-56-7-2367/) 4. [TN Dept. of Health — LBA application (T.C.A. §§ 63-11-301–311)](https://www.tn.gov/content/dam/tn/health/healthprofboards/behavior-analyst/LBA-Application.pdf) 5. [Evernorth Behavioral Health — Administrative Guidelines (September 2026, PCOMM-2026-191)](https://static.evernorth.com/assets/evernorth/provider/pdf/resourceLibrary/behavioral/ebh-provider-admin-guide.pdf) 6. [Tenn. Code Ann. § 56-7-109 — prompt payment of health insurance claims (FindLaw)](https://codes.findlaw.com/tn/title-56-insurance/tn-code-sect-56-7-109/) 7. [Tenn. Code Ann. 56-7-3705 — Prior Authorization Fairness Act timeframes](https://codes.findlaw.com/tn/title-56-insurance/tn-code-sect-56-7-3705/) 8. [29 CFR 2560.503-1 — ERISA claims procedure (eCFR)](https://www.ecfr.gov/current/title-29/section-2560.503-1) 9. [Tenn. Comp. R. & Regs. 0780-01-53 — Coordination of Benefits (group contracts)](https://publications.tnsosfiles.com/rules/0780/0780-01/0780-01-53.pdf) 10. [42 U.S.C. 1396a(a)(25) — Medicaid third-party liability](https://www.govinfo.gov/content/pkg/USCODE-2023-title42/html/USCODE-2023-title42-chap7-subchapXIX-sec1396a.htm) 11. [10 U.S.C. 1079(i)(1) — TRICARE pays after other coverage, Medicaid excepted](https://www.govinfo.gov/content/pkg/USCODE-2023-title10/html/USCODE-2023-title10-subtitleA-partII-chap55-sec1079.htm) 12. [CHAMPVA Guidebook (updated Jan. 1, 2025) — Other Health Insurance](https://www.va.gov/COMMUNITYCARE/docs/pubfiles/programguides/CHAMPVA-Guide.pdf) Payer policies change frequently and vary by plan, state, and funding type. This guide was compiled from the sources above and last reviewed October 2026; it is general information, not billing, legal, or clinical advice. Always verify current requirements against the payer's live policy and a benefits check for the specific member. Source: Carelu ABA Payer Directory — https://carelu.com/payers. Free to cite with attribution.