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.
Cigna met with the Florida Medical Association (FMA) and clarified that an earlier press release may have caused confusion among physicians about who would be affected by the new policy. Cigna described this as a miscommunication and stated that most practices will not be subject to the changes.
The FMA has expressed its intent to monitor how the policy is implemented. “We strongly oppose all inappropriate downcoding initiatives,” an FMA spokesperson said.
Physicians who experience what they believe are inappropriate downcoding adjustments from Cigna are encouraged by the FMA to report these cases via email. The association also invites members affected by other downcoding policies to contact them, so their advocacy team can better assess any broader impacts and determine if further action is needed. The FMA also offers direct assistance to members facing such issues.
