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Summary of Provider Newsroom U.S. commercial medical articles
Cigna·Family Medicine, Internal Medicine, General Practice +1 more·Claims & Billing
Effective date
Jun 1, 2025
We identified it
Jun 18, 2026
Summary
Cigna Healthcare will no longer reimburse advanced primary care management services effective June 1, 2025, as defined by CMS. Additionally, nine new specialty medical injectables have been added to the reimbursement restriction list requiring dispensing through Cigna-contracted specialty pharmacies.
Action Required
By June 1, 2025: Billing team must stop submitting claims for advanced primary care management services to Cigna Healthcare Medicare Advantage plans as these will not be reimbursed. Update billing system to flag these services. For specialty medical injectables, verify that all injectable claims are submitted through Cigna-contracted specialty pharmacies or obtain prior authorization before dispensing.