Rule Change for Patient Navigation Billing Is a Boon to Oncology Care, Practice Leaders Say

The CMS 2024 Medicare Physician Fee Schedule Final Rule brings significant changes to oncology care by allowing reimbursement for patient navigation services under new codes. This enables more patients to access navigators, enhancing communication, treatment adherence, and timely care. Patient navigation, proven effective over two decades, addresses the complexities of cancer care and is highly valued by patients. Reimbursement parameters include informed consent, nonfacility settings, and no time limits on service duration. The rule also covers caregiver training, telehealth, and social determinants assessment. Financially, it benefits practices by controlling costs and improving care quality. Despite room for growth, reimbursement for patient navigation marks a positive step towards equitable oncology care, reducing costs, and enhancing patient support.