G0023 Illness navigation Medicare reimbursement rates in Washington

G0023 covers principal illness navigation furnished by trained auxiliary personnel, such as a patient navigator or certified peer specialist, under a physician’s or other qualified practitioner’s direction. The work helps a patient with a serious, high-risk illness navigate care, coordinate appointments and services, and address barriers that interfere with treatment. Examples may include supporting a patient with cancer or dementia as the patient moves among clinicians and services; the patient’s illness and navigation needs must support the service, rather than the diagnosis alone. Navigation may be provided in a clinical practice or other setting where the practitioner directs the work.

Report G0023 for the monthly base service, which represents 60 minutes of navigation. Documentation should identify the illness-related navigation needs, activities performed, personnel providing them, and time for the month. G0024 describes additional monthly navigation time. CMS pays G0023 under the Physician Fee Schedule using work, practice expense, and malpractice RVUs; the practice-expense RVUs differ between office and facility settings.