Cigna will implement a new reimbursement policy called “Evaluation & Management Coding and Accuracy (R49)” starting October 1, 2025. The policy concerns how evaluation and management services are coded and reimbursed.
Cigna representatives met with the Florida Medical Association (FMA) to clarify the scope of the new policy. According to Cigna, only a small number of physicians will be impacted by the change. Cigna also stated that their initial press release may have caused confusion, leading many physicians to believe they would be affected when most will not. Cigna referred to this as a miscommunication.
The FMA has expressed its intention to monitor the policy’s effects. “We strongly oppose all inappropriate downcoding initiatives,” the FMA stated. The association is asking its members who experience what they believe are inappropriate downcoding adjustments from Cigna to contact them at jfowler@flmedical.org. FMA members affected by other downcoding initiatives are also encouraged to reach out. The FMA said this information will help its advocacy team evaluate the impact of Cigna’s policy and determine if further action is needed. The association will also provide direct assistance to affected members when possible.
