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NATIONAL POLICY RESOURCES - LOCAL ADVOCACY RESULTS

Advocacy

As cancer care professionals who experience the challenges of providing quality cancer care first-hand, AACP members are well positioned to educate decision-makers on how coverage and reimbursement issues affect community oncology. State and federal legislation can have a significant impact on the financial viability of local cancer programs, which is why it's so important that our members make their voices heard.

We want to hear from you! If there is a specific piece of legislation you want to know more about, an important resource we're missing, or if you want to get more involved, please contact us!

Implementing the New CMS Reimbursement Billing Codes for Patient Navigation Services

As of January 1, 2024, the Centers for Medicare and Medicaid Services introduced new codes so that Medicare could reimburse for patient navigation services. To address challenges of implementation, the Association of Cancer Care Centers, in partnership with WSMOS and 11 other state societies from AZ, CO, IN, IA, NV, NM, NY, NC, SC, WI, and WY, has a 4-part webinar series, Implementing the New CMS Reimbursement Billing Codes for Patient Navigation Services, hosted by Teri Bedard of Revenue Cycle Coding Strategies.


The New CMS Navigation Reimbursement Billing Codes: A 101

The 2024 Physician Fee Schedule included 7 new codes specific to care management. This webinar reviews how these differ from the care management codes available from the American Medical Association, common questions, and challenges for implementing these new codes. Access a PDF of the slides here.


Principal Illness Navigation (PIN) Services Documentation, Coding, and Billing

The 2024 Physician Fee Schedule includes four new codes specific to Principal Illness Navigation–Peer Support. With these new codes, providers will be able to bill for the services of navigators, social workers, and support personnel. This webinar goes into a deep dive, reviewing components of the new codes, answering common questions, and addressing challenges for providers. Access a PDF of the slides here.

STATE ADVOCACY

WIN! PASSED – SB 5396 – Sen. L. Wilson (R). Cost-sharing for patients for supplemental breast screening exams. Beginning January 1, 2024, for health plans that include coverage of supplemental breast examinations and diagnostic breast examinations, health carriers may not impose cost sharing for such examinations. “Diagnostic breast examination” means a medically necessary and appropriate examination, including an examination using diagnostic mammography, digital breast tomosynthesis, breast magnetic resonance imaging, or ultrasound, that is used to evaluate an abnormality seen or suspected from a screening examination for breast cancer, or detected by another means of examination. “Supplemental breast examination” means a medically necessary and appropriate examination, including an examination using breast magnetic resonance imaging or ultrasound, that is used to screen for breast cancer based an individual’s personal or family medical history, or additional factors that may increase the individual’s risk of breast cancer.


OTHER BILLS TO KEEP AN EYE ON: