Advocacy Update Aug. 19, 2025
IN THIS ISSUE / Aug. 19, 2025
Payer Advocacy
Academy addresses Cigna’s new E/M billing policy
On Aug. 8, the AADA met with Cigna to review its Evaluation and Management (E/M) Coding and Accuracy policy. Starting Oct. 1, 2025, Cigna will target physicians who frequently report Level 4 and 5 E/M CPT ® codes. When documentation on a claim does not support the higher-level code reported, Cigna may downcode it by one level.
Cigna explained this review is limited in scope and will not affect 97% of its network. Downcoded claims will be noted on the remittance advice, indicating the reported codes did not support the billed level of service.
Identified practices will not receive advance notice. However, physicians may call Cigna at 800-88CIGNA to determine if they are included in the review program. They may also request claim reconsideration and/or removal from the program.
Details about the “Reimbursement Policy Commercial – R49: Evaluation and Management Coding and Accuracy” update will be posted on the Cigna for Health Care Professionals portal (CignaforHCP.com) and in the Provider Newsroom.
Regulatory Affairs
AADA member selected for Partnership for Quality Measurement’s Pre-Rulemaking Measure Review Clinician Committee
On Aug. 8, AADA member Christopher M. DiMarco, MD, FAAD, Deputy Chair of the Performance Measurement Committee, and Stephanie Braxton, AADA Senior Manager, Quality Measures and Analysis, were appointed to serve three-year terms on the Partnership for Quality Measurement’s (PQM) Pre-Rulemaking Measure Review (PRMR) Clinician Committee.
The PQM PRMR Clinician Committee provides recommendations to CMS on the selection of quality measures under consideration for use in several CMS programs, including MIPS.
AADA presents at FDA Advisory Panel on dermal fillers
On Aug. 13, AADA Regulatory Policy Committee member Natalie Curcio, MD, FAAD, participated in the FDA’s General and Plastic Surgery Devices Panel meeting regarding indications for use for dermal filler devices in the décolletage. The AADA addressed benefits and risks of décolletage injection, removal of dermal filler material, and patient preference.
AADA News
Contribute to SkinPAC
As of Aug. 14, SkinPAC has raised $791,944 from 720 individuals. Contribute online at www.skinpac.org or by texting SkinPAC to 71777.
Help us keep up the momentum as we advocate for Medicare physician payment reform. SkinPAC helps strengthen our relationships on Capitol Hill and reinforces our grassroots and lobbying efforts.
Email skinpac@aad.org with any questions.
The political purpose of the American Academy of Dermatology Association Political Action Committee ("SkinPAC") is to solicit and receive contributions to be used to make political campaign expenditures to those candidates for elective office, and other federal political committees, who demonstrate understanding and interest in the view and goals of the American Academy of Dermatology Association.
Contributions to SkinPAC are not deductible for federal income tax purposes. Contributions to SkinPAC must be made from your funds and may not be reimbursed. SkinPAC cannot accept contributions from corporate accounts. Any recommended contribution amount is merely a suggestion. All AADA members have the right to contribute more or less or refuse to contribute without reprisal. Federal law prohibits us from accepting contributions from foreign nationals. Federal law requires us to use our best efforts to collect and report the name, physical address, occupation, and name of the employer whose contributions exceed $200 in a calendar year.
