The Partnership & Freedmen's Health Consulting hosted two stakeholder discussions about the CY2026 Medicare Physician Fee Schedule proposed rule and policy updates that affect delivery and payment opportunities for services to address upstream drivers of health.
The 2024 and 2025 Physician Fee Schedule Final Rules advanced significant policy changes designed to address Upstream Drivers of Health, including services codes for Community Health Integration (CHI) and Principal Illness Navigation (PIN) that provide a reimbursement pathway for community health workers and other auxiliary personnel. These codes also allow Medicare providers to contract with community-based organizations and community care hubs, which can provide staffing to address upstream drivers of health and navigation.
The Partnership to Align Community Care & Freedmen's Health Consulting hosted two stakeholder discussions about the CY2025 Medicare Physician Fee Schedule proposed rule and policy updates that affect delivery and payment opportunities for services to address upstream drivers of health.
August 6, 2024 Session: Stakeholder discussion included a brief review of the CY2024 PFS final rule, an overview of the CY2025 PFS proposed rule request for information (RFI) re: CHI/PIN codes, and addressed FAQs.
August 14, 2024 Session: Stakeholder discussion included an overview of submission guidelines, potential responses to the RFI re: CHI/PIN codes, the Advanced Primary Care Model RFI, and Q&A.
