For your convenience, we have posted separate HCFA forms for your EAP and Behavioral Health claim needs. Please use the appropriate claim form to expedite your payment. You can download these forms or, for EAP and outpatient Behavioral Health services, you can use our Online Web Claims tool to receive even faster and more accurate claim payment — and this service is free to you (this service is not available for IOP or higher levels of care).

Please note that HIPAA has required us to change our EAP CPT code. In the past, you were using EAP09 for all of your EAP claims (including SAP). We appreciate your patience while we worked to find a new CPT code. You most recently were using 90806 for EAP claims and 90801 for SAP EAP claims. In order to separate EAP claims from Behavioral Health claims, effective immediately please use the CPT code of 99404 for all EAP claims (including SAP).

A note about EAP and our Integrated Products: If you are credentialed to be an EAP provider with Cigna Behavioral Health, you are well aware of our face-to-face counseling programs. The majority of our EAP customers have purchased a 1-3 model (Assess and Refer). This product allows for the provider to have up to three sessions to formulate an assessment and make a referral on to the behavioral health benefits. Two things to remember: (1) if it is an appropriate clinical referral, the provider can refer to themselves; and (2) the provider must call CBH to close the EAP case when the assessment is completed-after the first, second or third session.

Our Short Term Counseling product has begun to see more membership. These products are more than 3 sessions and sometimes up to 12. The goal of this product is to try to complete the course of counseling within the EAP and if you assess that this is not an appropriate goal, you should refer on to the behavioral health benefit. The provider must call CBH when the EAP STC case is closed.

Standard CMS-1500 (formerly HCFA 1500)

EAP-Only CMS-1500 (formerly HCFA 1500)

Standard UB04 (formerly UB92)