BLOGS

Physicians looking at a projected $50K revenue loss from undercoding and R49 downcoding

The $50,000 Mistake: How Cigna’s R49 Policy Could Devastate Physician Practices

With only days left before October 1, physicians must understand what’s really at stake. A mid-sized practice that bills for 20 high-level visits per week could lose $4,000 to $5,000 per month if claims are downcoded. Over 12 months, this amounts to nearly $50K in lost reimbursements. On October 1, 2025, Cigna Healthcare will enforce its new Evaluation and Management (E/M) Coding Accuracy (R49) Policy. This change is significant for many physicians; it represents a seismic s

Sep 166 min read

The Impact of Physical Therapy Modifiers on Reimbursement (2026)

In 2026, modifiers such as KX, CQ, and CO will be under tighter scrutiny than ever before. This means that physical therapy clinics without airtight processes are not just risking denials; they’re also risking audits and penalties.

Aug 253 min read

Physical Therapist in a casual light blue button-up shirt in a PT clinic with his hand on his forehead worrying about the constant write-offs.

Who Likes Write-Offs in PT Clinics?

Let’s face it, physical therapy billing write-offs are nobody’s favorite line task. Every week, PT clinics quietly sweep denied or unpaid claims under the rug, assuming they’re too small or too late to chase. It feels easier in the moment, but behind each “adjustment” lies potential revenue slipping through your fingers.

Jun 263 min read