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Summary of Provider Newsroom U.S. commercial medical articles
Act
immediately
Effective date
Oct 1, 2025
Identified
Jun 18, 2026
Summary
This is a monthly summary of all Cigna Healthcare policy updates published in November 2025, including a new E/M reimbursement policy (R49) that reviews high-level evaluation and management codes for accuracy, effective October 1, 2025. The summary also covers changes to prior authorization processes, portal enhancements, and various administrative updates.
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What to do
immediately · 4 steps
01Review all E/M coding practices for CPT codes 99204, 99205, 99214, 99215, 99244, and 99245 to ensure accurate level selection and documentation.
02Train providers on the new R49 reimbursement policy requirements.
03Update billing system to flag these codes for additional review before submission.
04Claims for these codes may face increased scrutiny for coding accuracy starting October 1, 2025.
Codes mentioned
992049920599214992159924499245
Original notice
Summary of Provider Newsroom U.S. commercial medical articles
providernewsroom.com · Always check the source before changing claims.
Related changes
See all Cigna changes →2025 Clinical, reimbursement, and administrative policy updatesHighEffective Mar 15, 2025 · Claims & BillingSummary of Provider Newsroom U.S. commercial medical articlesHighEffective Oct 1, 2025 · GeneralSummary of Provider Newsroom U.S. commercial medical articlesMediumEffective Oct 1, 2025 · GeneralProfessional claims for evaluation and management servicesHighEffective Oct 1, 2025 · CodingBrowse every Cigna change in the policy list