Cigna has announced a new reimbursement policy called “Evaluation & Management Coding and Accuracy (R49),” which will take effect for services provided on or after October 1, 2025. The company stated that this policy is not expected to impact most physicians.
According to Cigna representatives who met with the Florida Medical Association (FMA), only a small number of physicians will be affected by the new policy. They noted that the initial press release caused confusion among physicians, leading many to believe they would be impacted. Cigna attributed this to a miscommunication on their part.
The FMA has expressed its intent to monitor the situation closely. “We strongly oppose all inappropriate downcoding initiatives,” the FMA stated. The association is encouraging its members who experience what they believe are inappropriate downcoding adjustments from Cigna to report these instances by emailing jfowler@flmedical.org. The FMA is also inviting members affected by other downcoding initiatives to reach out.
The information collected will help the FMA’s advocacy team assess the effects of Cigna’s policy and determine if further action is necessary. The association has also committed to providing direct assistance to members who are affected whenever possible.
