WASHINGTON, D.C. – July 14, 2023 – The Center for Medicare and Medicaid Services (CMS) released the proposed Calendar Year 2024 Medicare Physician Fee Schedule late yesterday, including coding changes to allow for reimbursement for some patient navigation services and expanded access to telehealth services.
“We applaud this first step forward by the administration in recognizing the unique and impactful contributions patient navigators have to improving the outcomes of individuals with cancer and their caregivers,” said Dr. Karen E. Knudsen, CEO of the American Cancer Society and American Cancer Society Cancer Action Network (ACS CAN). “Prioritizing patient navigation is particularly important to achieve the President’s Cancer Moonshot goals of cancer health equity, as the greatest impact of professional navigators is oftentimes addressing the needs of under-resourced or marginalized communities.”
Navigating the United States health care system can be confusing and complicated and making decisions after receiving a complex medical diagnosis such as cancer is challenging for anyone but particularly for populations that have been historically marginalized. Patient navigation programs in oncology offer individualized assistance and support to patients to help them overcome health care system barriers, facilitate timely access to quality care and to help lessen the cancer burden during and after treatment.
“Navigators are key to the delivery of timely, high-quality, personalized cancer care, and the proposed change in the Medicare Fee Schedule is an important step forward towards a future state where all types of navigation will be sustainable, scalable, and accessible by all,” added Knudsen. “Several studies over decades have demonstrated consistent and robust benefits when professional navigators engage persons with cancer in accessing the right resources, at the right time, in the right way. We are pleased that CMS is acknowledging that cancer patients can benefit from patient navigation services and encourage Congress to build on this administrative action to pursue additional avenues to make sure that the services are widely available to all cancer patients who can benefit.”
In addition to the patient navigation reimbursement, CMS proposes to implement several telehealth-related provisions of the Consolidated Appropriations Act, 2023 (CAA, 2023) in the CY 2024 Physician Fee Schedule. We appreciate that CMS is expanding access to telehealth services pursuant to the CAA, 2023 which temporarily extended many of the telehealth flexibilities allowed during the COVID-19 public health emergency, such as allowing patients to receive telehealth services in their home. The American Cancer Society and ACS CAN support the use of telehealth services as an option for patients to improve their access to care.