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CMS Proposal: Scope of Reimbursable Navigation Services

  • Clara Lambert
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CMS Proposal: Scope of Reimbursable Navigation Services was created by Clara Lambert

Posted 7 months 3 weeks ago #103
CMS has proposed allowing reimbursement of navigation services under the new codes GXXX3 and GXXX4 to include the following activities: (a)   Person-centered assessment performed to better understand the individual context of the serious, high-risk condition(b)   Identifying or referring patient (and caregiver or family, if applicable) to appropriate supportive services(c)   Practitioner, home-, and community-based care coordination(d)   Health education(e)   Building patient self-advocacy skills(f)    Health care access / health system navigation(g)   Facilitating behavioral change as necessary for meeting diagnosis and treatment goals(h)   Facilitating and providing social and emotion support to help the patient cope with the condition, social determinants of health need(s), and adjust daily routines to better meet diagnosis and treatment goals(i)    Leverage knowledge of the serious, high-risk condition and/or lived experience when applicable to provide support, mentorship, or inspiration to meet treatment goals  Are there any services or tasks you carry out in your current practice that are not included above that should be included? CMS is seeking feedback from navigators about the new proposed codes for PIN services. You may discuss more than one topic in your comments to CMS. When submitting comments on this topic, please reference:When commenting, please also reference file code CMS-1784-P.88 FR 52262 (proposed August 7, 2023) – Medicare and Medicaid Programs; CY 2024 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies, section II.E.(27)(e)(ii).
by Clara Lambert

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  • Rosemary Wolfe
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Replied by Rosemary Wolfe on topic CMS Proposal: Scope of Reimbursable Navigation Services

Posted 7 months 3 weeks ago #104
Hi Clara,

Thank you for posting!  I would encourage everyone to please take some time to look at the proposal and add your most needed and important opinions.  

Thank you!
 
by Rosemary Wolfe

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