Cigna Fee Schedule

Important Information 

With effect from 17 June 2022, all procedures that would typically involve the administration of local anaesthetic are inclusive of this element of care, therefore AC100, X3800 and X3520 should not be billed additionally. Do not add these codes into the procedure list, as the calculation will be incorrect.

These fees are effective from . Please note that our fee schedule search facility does not currently highlight any ineligible combinations of codes. Before billing you should check here.

Cigna Fee Schedule

We expect all accredited Cigna providers to abide by The Cigna Fee Schedule, the schedule contains fair and reasonable maximum fees for Surgery and Anaesthesia, as well as guideline fees for Initial and Follow up consultations. These fees are based on complexity, average duration of the procedure, information from our claims experience, the CCSD schedule and benchmarked against other fee schedules in the public domain in the United Kingdom. Please use the search function to calculate your fees.

Due to evolving medical practice, The Cigna Fee Schedule is reviewed periodically and therefore, complexities and/or fee values of procedures may change, maximum procedure fee reimbursement could go up or down.

Before treating a Cigna member

All practitioners should advise Cigna costs of any treatment (including consultations) being provided. If fees exceed the Cigna Fee Schedule, practitioners should advise the member prior to treatment taking place and Cigna reserves the right to shortfall the balance.

Consultation fees and surgery/anaesthetist fees represent a significant element of total claims costs in private medical insurance and subsequently, have a major effect on premiums. For premiums to remain affordable, practitioners, private facilities and health insurers need to work together to provide quality private healthcare at a reasonable and affordable price.

Guideline fees for Consultations

• Initial Consultation – face to face - £205
• Follow-up Consultation – face to face - £145
• Initial Consultation – remote - £205 (where clinically appropriate)
• Follow-up Consultation – remote - £145 (where clinically appropriate)
• Extended Physician Consultation - £250 (over 40 mins) 

Other important information

For further information on Consultations and all other information on how accredited practitioners should interact with Cigna, in relation to services that may not be eligible for reimbursement, please read our Terms and Conditions section.

CCSD schedule

Cigna is a member of The Clinical Coding and Schedule Development (CCSD) group. The CCSD schedule contains industry standard codes for surgical procedures and diagnostic tests in UK private healthcare. Their key initiative is to develop a common set of codes and descriptions across the UK private healthcare sector.

The CCSD schedule is reviewed regularly and reflects current medical practice. At each review, new codes are added, existing codes updated and some codes deleted. Please go to ccsd.org.uk to view the schedule and to learn more about the objectives of CCSD.