Biden Cancer Moonshot Introduces New Billing Codes for Patient Navigation

In January 2024, the Biden Cancer Moonshot delivered six codes to report patient navigation services for payment. The Cancer Moonshot team recently hosted a Q&A session during which several resources were shared with further information on the Principal Illness Navigation (PIN) codes. AACI has compiled highlights of these resources for our cancer center members:

Readout of White House Q&A Session on Navigation Codes
Among other resources, this readout includes a link to the Centers for Medicare & Medicaid Services (CMS) 2024 Health Equity Services Medicare Learning Network Article for further information on the Principal Illness Navigation (PIN) codes.

2024 Physician Fee Schedule FAQ
As discussed during the Q&A, PIN services can be furnished in both facility and non-facility settings, and CMS has created payment rates under the Physician Fee Schedule (PFS) that appropriately reflect the resources involved in furnishing these physicians' services in an institutional or facility setting, and outside of such settings. CMS has released an FAQ about services to help address health-related social needs in the 2024 PFS final rule, including caregiver training, social determinants of health risk assessment, community health integration, and principal illness navigation.

Please direct questions for AACI to Senior Program Manager Kate Shaw or Senior Government Relations Manager Jaren Love.

Biden Cancer Moonshot Announces Commitments From Leading Health Insurers and Oncology Providers 
Building on this progress, in March the Biden Cancer Moonshot announced commitments from seven leading health insurance companies expanding access to navigation services to help patients and their families navigate health care treatments for cancer and other serious illnesses. In addition, the Moonshot team announced 40 comprehensive cancer centers—more than half of which are members of AACI—and community oncology practices nationwide that commit to using the new navigation codes to provide patient navigation services to people facing cancer.

View the White House Fact Sheet
AACI Joins the Conversation on Patient Navigation

Patient navigation has become an essential piece of the health care puzzle in the United States, where it plays a pivotal role in bridging the gaps in health care accessibility and affordability. Last month AACI published two articles on the current state of patient navigation.

Read Patient Navigation: Reducing Disparities in Cancer Care, on the Coalition for Health Funding Blog
Read the March 2024 AACI Commentary