Readout of White House Q&A Session on Navigation Codes
As part of his Unity Agenda, President Biden set the goal of making navigation services accessible to Americans facing cancer. Cancer navigation is personalized assistance to patients, caregivers, and families to help identify and resolve barriers to high-quality and timely cancer care through care coordination and advocacy. President Biden has prioritized increasing access to navigation services, which improve patient outcomes, reduce healthcare costs, and advance health equity. With leadership from the First Lady, as of January 1, 2024, the Biden Cancer Moonshot delivered six codes to report navigation services for payment.
On Friday, February 23, the Biden Cancer Moonshot hosted a virtual Question & Answer session with experts from the Centers for Medicare & Medicaid (CMS) and the American Medical Association (AMA) for an audience of key cancer advocates, navigators, payers, professional associations, and clinicians to address questions related to the navigation codes.
As part of the session, Dr. Douglas Jacobs, Chief Transformation Officer in the Center for Medicare at CMS, provided an overview of the Principal Illness Navigation (PIN) codes. PIN services focus on removing barriers to care and include care coordination, health education and patient self-advocacy skills development, health system navigation, and access to community-based social services to address unmet social determinants of health, including food and housing insecurity, and transportation needs. Dr. Jacobs noted that these are the first codes to describe services involving community health workers, care navigators, and peer support specialists and highlighted their recently released 2024 Health Equity Services Medicare Learning Network Article for further information on the PIN codes.
Following CMS, Dr. Barbara Levy, Vice-Chair, CPT® Editorial Panel; Chair, CPT Assistant Editorial Board at the AMA, provided an overview of Principal Care Management (CPT) codes and the appropriate use of these codes in reporting clinical navigation services. Clinical navigation focuses on medical care coordination and education and is typically provided by clinical staff, including nurses and licensed clinical social workers. By walking the audience through a case study, Dr. Levy explained the use of these codes to address medical, psychological, and social needs manifested by a complex chronic condition such as cancer.
Following these presentations, the session opened to questions from participants, where CMS, AMA, and the Biden Cancer Moonshot team addressed questions about training and certifying auxiliary personnel for PIN codes, how navigation codes can be used in the continuum of care, and the intersection between providers and community-based organizations in advancing navigation services.
This session was an important step in the Biden Cancer Moonshot’s efforts to bring payers, providers, and key members of the community together with the shared goal of expanding navigation access and delivering on President Biden’s promise of providing patient navigation support to every American facing cancer.
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