Principal Illness Navigation
The 2024 PFS final rule established 4 HCPCS codes related to Principal Illness Navigation:
- G0023
- G0024
- G0140
- G0146
These codes account for services provided in relation to a patient’s serious, high-risk conditions. You can provide these services in addition to other care management services, as long as time and effort aren’t counted more than 1 time and the services are reasonable and necessary.
Services related to principal illness navigation must take place under a billing physician’s general supervision after an initiating visit.
- Codes G0023 and G0024 refer to principal illness navigation services.
- Codes G0140 and G0146 refer to principal illness navigation-peer support. These are specific to patients with high-risk behavioral health conditions.
With these codes, CMS allows payment for up to 18 hours of principal illness navigation per year.
- Codes G0023 and G0140 are for providers billing 60 minutes per calendar month for a total of 12 hours per year
- Additional payment is available for providers who use G0024 and G0146 for each additional 30 minutes per calendar month for a total of 6 hours per year