Following widespread concerns from organized medicine, including a sign-on letter (PDF) from the AMA and over 100 other organizations representing physicians and health care professionals, Cigna updated its modifier 25 policy (PDF) to announce a delay in implementing the required submission of documentation to support the use of modifier 25 when billed with evaluation and management CPT codes 99212–99215 and a minor procedure. This policy would place enormous, unjustified administrative burdens on physician practices.
Cigna provided the following details regarding its announced delay:
- 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 looks 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.
The AMA will provide updated information as it becomes available.