Non-Participating Laboratory Services - (A001)

Cigna reimburses covered laboratory and pathology services from non‑participating providers at the out‑of‑network benefit level, except in limited cases (true emergency visits, applicable federal/state law, or when no participating lab can provide the medically necessary covered service) where in‑network reimbursement may apply. Exceptions require Cigna authorization/approval, supporting documentation (e.g., emergency visit proof, legal citation, or proof of non‑availability), review under Cigna’s Network Adequacy Policy, and must be consistent with the member’s benefit plan and medical necessity.

"Reimbursement of covered laboratory and pathology services from non-participating laboratories and non-participating health care professionals at the applicable out-of-network benefit level."

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