CommercialReimbursementHigh impact
Summary of Provider Newsroom U.S. commercial medical articles
Cigna·Claims & Billing
Effective date
Oct 1, 2025
We identified it
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.
Action Required
Immediately: Review all E/M coding practices for CPT codes 99204, 99205, 99214, 99215, 99244, and 99245 to ensure accurate level selection and documentation. Train providers on the new R49 reimbursement policy requirements. Update billing system to flag these codes for additional review before submission. Claims for these codes may face increased scrutiny for coding accuracy starting October 1, 2025.