After previously stating its intent to stop paying the professional component of clinical pathology (PC/CP), Cigna has reversed course and will continue paying for these services after receiving significant pushback from the College of American Pathologists and others pathology advocacy groups.
On Tuesday, June 8, CAP shared the following update on its website:
“In response to the CAP’s engagement, Cigna informed the CAP on June 7 that the decision is imminent. The CAP learned health insurance payer Cigna plans to continue reimbursing pathologists for the professional component of clinical pathology services. A formal update regarding the policy to pay for the professional component of clinical pathology would be forthcoming soon.”
In its initial update to the Modifier 26 Professional Component Policy published April 12, 2021, Cigna said codes inappropriately billed with a 26 modifier would be denied beginning July 11, 2021. Further reading showed this would include the PC for clinical pathology claims.
Pathologists in several states would have seen their reimbursements negatively impacted if the change had been allowed to take effect. As is stands, Cigna is one of the last commercial payers to still reimburse PC/CP.
A formal announcement from Cigna is expected soon, according to CAP.
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