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Cigna Downcoding Alert: A Statement from MAG*
Cigna has announced a new reimbursement policy that will take effect on October 1, 2025. This policy will allow the insurer to automatically downcode certain high-level Evaluation and Management claims, including codes 99204 through 99205, 99214 through 99215, and 99244 through 99245. Physicians who are placed on a Cigna review list may see these claims reduced by one level of service even when fully documented, and the only way to restore payment will be through an appeal that requires resubmission of the full medical record.
This change could result in lost reimbursement for properly coded visits, additional administrative burden for practices, and delays that ultimately affect patients. Other state medical associations are already opposing this policy, and the Medical Association of Georgia (MAG) is committed to ensuring that Georgia physicians and their patients are protected as well.
The Commissioner’s office needs to hear directly from Georgia physicians about the potential harm this policy will cause. View the full alert and petition from the Medical Association of Georgia here.
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