Institute for Comprehensive Cancer Care Services: The Centers for Medicare & Medicaid Services Will Pay for Patient Navigation—Now What?

Abstract

In Brief Following decades of research demonstrating the efficacy of patient navigation on clinical and patient-reported outcomes, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that pays for patient navigation and navigation-related services effective January 1, 2024. This article reviews the new codes to reimburse for principal illness navigation (PIN) services, social determinants of health (SDOH) assessment, community health integration, and PIN-Peer Support (PIN-PS). A description of the codes, how to use them, who can perform services, and next steps for the field are reviewed.