A practical approach to PIN services reimbursement
CMS now reimburses for work your clinic is already doing
Patient Discovery combines care coordination, patient engagement, and revenue cycle management into a single solution that streamlines patient support and optimizes reimbursements.
The 2026 Physician Fee Schedule includes an 11% increase in reimbursement amounts for Principal Illness Navigation (PIN) services, including:
Non-clinical services that address social and practical barriers to care
Work performed by non-licensed staff (ex. care coordination, financial support counseling)
Ongoing patient support across multiple encounters, not just one-time visits
Track and bill without leaving the patient record
Integrated directly into your EMR system, Patient Discovery:
Engages patients to proactively identify SDoH needs before appointments, initiating the SDoH assessment and reducing the burden of discovery on care teams
Operationalizes & centralizes the identification, documentation, and billing of SDoH interventions, ensuring full CMS compliance
Enables seamless care coordination by providing a unified platform for clinical and non-clinical staff to manage patient needs
Optimizes reimbursement opportunities for SDoH, PIN, and CHI services
Improves patient outcomes and experiences by facilitating the ongoing delivery of patient-centered care
Patient support can be a reimbursement driver
Assisting serious high-risk patients with services like coordinating care, addressing social needs, navigating the complexities of the healthcare system, and providing education are reimbursable for clinical and non-clinical staff alike.
For Providers
SDoH risk assessment via standardized tool
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Prioritizes the need
to identify social needs
that may influence care or treatment decisions.
5 min. minimum reviewing, discussing, documenting needs, every 6 months (Medicare)
G0136: $18.67
5 min. minimum reviewing, discussing, documenting needs, quarterly (Commercial)
G9919/G9920: $33.89
For Care Navigators
PIN services
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Focuses on ensuring access for patients as they navigate the healthcare system, including patients without social needs. Works in parallel to Community Health Integration (CHI) and reimburses for non-clinical staff activities like care coordination, health education, patient advocacy, and referrals.
60 min. per month
G0023: $79.25
Add’tl 30 min. per month G0023+G0024: $49.45