Reasonable and Customary

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	I was able to get CIGNA to pay 60% of my first 2 monthly invoices for ABA. The third one has been paid, but the covered balance was limited to $240 and paid at 60% of that - $144. $144 for 74 hours of one-on-one, in-home, ABA therapy!! CIGNA is saying that $240/month is the reasonable and customary charge for this service.  We are using a CPT code of 90808. I want to know if anyone has ideas that I can include in my appeal. I am about to go into more detail the resources that NormayMom has provided but I can use all the help I can get. THANKS. Kara39885.2227199074Sorry, I couldn't get our insurance company to pay anything at all! Oh, how I wish there were some standards for this sort of thing! Good luck with your appeal, and please keep us posted!
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