Prescription Digital Therapeutics - (0565)

Cigna covers prescription digital therapeutics only when all criteria are met: documented prescription by a licensed practitioner, FDA approval and use per FDA indications, medical necessity to treat a disease/symptom, peer‑reviewed evidence of safety/effectiveness, and not primarily for convenience (remote therapeutic monitoring is integral and not separately reimbursable). Devices and HCPCS codes E0738 (IpsiHand), E0739 (Motus Hand/Foot), E1905 (RelieVRx) and E1095, as well as wellness/diagnostic or non‑prescription digital health apps, are considered experimental/investigational and are not covered.

"This Coverage Policy addresses prescription digital therapeutics (PDTs) in the adult and pediatric populations."

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