Cigna has announced a new reimbursement policy, “Evaluation & Management Coding and Accuracy (R49),” which will take effect for services provided on or after October 1, 2025. The policy concerns how evaluation and management (E/M) codes are reviewed and reimbursed.
According to the Florida Medical Association (FMA), Cigna representatives stated that the new policy will affect very few physicians. Cigna also acknowledged that an earlier press release had led many doctors to believe they would be impacted, which the company described as a miscommunication.
The FMA has expressed interest in closely monitoring the implementation of this policy and determining if further advocacy is needed. “We strongly oppose all inappropriate downcoding initiatives,” said the FMA.
The FMA is asking its members who receive downcoding adjustments from Cigna that they believe are inappropriate to contact the association at jfowler@flmedical.org. The FMA has also invited members affected by other downcoding actions to reach out, noting that this information will help its advocacy team assess the policy’s impact and decide if additional action is required. The FMA stated it will provide direct assistance to affected members when possible.
