December 13, 2024
To support access to quality, cost-effective care for your patients with a medical plan administered by Cigna Healthcare, we routinely review clinical, reimbursement, and administrative policies for potential updates. As a reminder, reimbursement and modifier policies apply to all claims, including those for your patients with “G” ID cards.
Planned medical policy updates*
| Policy name | Update | Effective date |
| Bilaterial Procedures (M50) | We will reimburse bilateral procedure codes billed with modifier 50 at 150 percent of the fee schedule or other allowed amount. The claim line will be administratively denied when modifiers LT or RT are billed instead of modifier 50. | March 15, 2025, for dates of service on or after this date. |
| Preventive Care Services (A004) | Coverage for certain services billed as preventive will be subject to criteria including age, frequency, and diagnosis codes submitted. We may determine that related claims are not reimbursable, or claims may be reimbursed with the appropriate cost share under the medical benefit. | March 17, 2025, for dates of service on or after this date. |
* Please note that the planned updates are subject to change. For the most up-to-date information, please visit the Cigna for Health Care Professionals website (CignaforHCP.com).
Additional information
For more information about our monthly policy updates, visit CignaforHCP.com > Resources > Coverage Policies > Policy Updates.
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