05/31/2023

Cigna Update to Modifier 25 Policy

NEWS FROM THE AMA:

We wanted to alert you that Cigna has updated its modifier 25 policy to announce a delay in implementing the required submission of documentation to support the use of modifier 25 when billed with E/M CPT codes 99212 – 99215 and a minor procedure.

Although the AMA has not yet received a formal response to the sign-on letter sent in April to Cigna about the policy, we have received the following details regarding its announced delay:

 Cigna is delaying the implementation of the modifier 25 policy.

• Cigna is currently reevaluating this reimbursement policy update, which will delay implementation.
  
  
• Cigna will look to implement this policy later, when it can optimize the provider experience and perform additional provider education in partnership with key national medical associations.
  
  
• Cigna will communicate a new implementation date and additional details later.
  
  
• Cigna appreciates your partnership and patience and look forward to working more collaboratively with provider partners, medical associations, and their membership to ensure that modifier 25 is used appropriately and in alignment with national guidelines and industry standards.

 Stay tuned for  any additional information as it becomes available.

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Information courtesy of Jim Pawelski
Director, Federation Relations | American Medical Association