ACP Letter to NAIC on Evaluation/Management Downcoding

ACP writes to express concerns regarding a practice among private payers related to reimbursement for Evaluation and Management (E/M) services.

Danielle Sakowitz

NAIC, evaluation management, downcoding, Cigna, Aetna, Humana, Anthem, E/M, automatic downcoding, level 4, level 5, administrative burden, algorithm, transparency, private payer, clinical judgement, insurance, complexity of care, medical record, coding, billing

Mon, 10/27/2025 - 9:40 AM EDT

Mon, 10/27/2025 - 9:44 AM EDT

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acp_letter_to_naic_on_eval_management_downcoding_2025.pdf

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2025