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 company has stated that this initiative is not expected to impact most physicians.
According to representatives from Cigna who met with the Florida Medical Association (FMA), there was confusion following the initial announcement of the policy. Cigna clarified that the majority of physician practices will not be affected by the changes and described the misunderstanding as a result of miscommunication.
The FMA has expressed concern about the potential effects of downcoding policies and intends to monitor how the new policy is implemented. “We strongly oppose all inappropriate downcoding initiatives,” an FMA spokesperson said.
The FMA encourages physicians who believe they have been inappropriately affected by Cigna’s downcoding adjustments to contact them via email at jfowler@flmedical.org. The association also invites members who are impacted by other downcoding policies to report their experiences. This feedback will help the FMA advocacy team evaluate the overall impact and determine if further action is needed. The FMA has stated it will provide assistance to affected members when possible.
More information from Cigna about the policy can be found here.
