The Partnership hosted a webinar event for CBO and community care hub, health plan, health system, and provider stakeholders and other advocates seeking to understand what proposed coding and payment changes in CY2024 Physician Fee Schedule could mean for addressing upstream drivers of health and the overall effort to align health and community care ecosystems.
As part of the proposed CY2024 Physician Fee Schedule, CMS is proposing coding and payment changes for services to address upstream drivers of health through separate payments for Community Health Integration (CHI), SDOH Risk Assessment, and Principal Illness Navigation (PIN) services. The proposed codes are the first that include community health workers, care navigators, and peer support specialists, and that allow these services to be provided by personnel employed by community-based organizations (CBOs)under the general supervision of the billing practitioner. Also included are changes to the payment mechanism for SDOH risk assessment activities—including allowing assessment as an optional additional element with additional payment during the annual wellness visit. Other potentially significant updates for evaluation and management visits, telehealth services, outpatient diabetes self-management programs, and behavioral health services are included in the proposed rule.
The Partnership to Align Community Care hosted a webinar event for CBO and community care hub, health plan, health system, and provider stakeholders and other advocates seeking to understand what proposed coding and payment changes could mean for addressing upstream drivers of health and the overall effort to align health and community care ecosystems. Attendees received an overview and discussion of these updates and opportunities to inform the public comment process.
