CommercialAdministrativeMedium impact
2027 Cigna Care Designation and Tier 1 results
Cigna·Coverage
Effective date
Jan 1, 2027
We identified it
Jul 16, 2026
Summary
Cigna Healthcare is implementing a new 2027 Care Designation (CCD) and Tier 1 provider evaluation program that separates primary care providers (PCPs) from specialty care providers (SCPs) for assessment. Tier 1 designation will display in Cigna directories starting October 2026 (preview) and become effective January 1, 2027, potentially affecting patient copayments and coinsurance based on provider tier status. Practices must submit reconsideration requests by August 17, 2026 if they want changes reflected in the October preview.
Action Required
By August 17, 2026: Providers and billing teams should review their 2027 CCD and Tier 1 results when communications arrive in June 2026. If discrepancies or data inaccuracies are identified, submit reconsideration requests via Cigna.com/CCDRequest, email (PhysicianEvaluationInformationRequest@CignaHealthcare.com), or fax (866.448.5506) to ensure corrections appear in the October 2026 preview. Include practice name, TIN, full address, and supporting documentation. Billing teams should monitor for Tier 1 designation updates in October 2026 and verify copayment/coinsurance structures align with the new tier assignments effective January 1, 2027. Update internal provider lists and billing software to reflect Tier 1 status to ensure accurate patient cost-sharing at point of service. No changes to billing codes or prior authorization processes are required, but patient benefits will differ based on whether providers are designated Tier 1.