Last week, APMA submitted a sign-on letter to Cigna, urging it to rescind its problematic Modifier 50 reimbursement policy as it relates to bilateral imaging. This APMA-led letter was also signed on by the American Academy of Orthopaedic Surgeons, and five other orthopedic specialty societies. Cigna’s policy recently reduced reimbursement for imaging services that have a bilateral indicator of "3" (most radiological services) from 100 percent for each service to 50 percent for the second service.
In this departure from Medicare guidance, Cigna is not properly recognizing the cost, effort, risk, time, materials, or decision making associated with performing these services bilaterally. APMA and the undersigned societies requested a response and a meeting with Cigna to discuss this inappropriate policy. APMA will continue to update members on developments on this issue.
Members can read this letter and other past advocacy letters at www.apma.org/CommentLetters. Contact the APMA Advocacy Department with any questions or concerns.