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. According to Cigna representatives, the policy is expected to impact only a small number of physicians. They stated that an earlier press release may have caused confusion among physicians about the policy’s reach. Cigna characterized this as a miscommunication.
The Florida Medical Association (FMA) is monitoring the situation to assess whether further advocacy is necessary. “We strongly oppose all inappropriate downcoding initiatives,” the FMA stated.
Physicians who experience what they believe are inappropriate downcoding adjustments from Cigna are encouraged to notify the FMA by email at jfowler@flmedical.org. The FMA also invites members affected by other downcoding initiatives to contact them. This information will help the association’s advocacy team determine the impact of Cigna’s new policy and consider if additional action is needed. The FMA says it will provide direct assistance to affected members when possible.
