Press Releases

CMS Includes Reimbursement for Oncology Patient Navigation in CY24 Medicare Physician Fee Schedule Proposal
Jul 14, 2023
Proposal also expands access to telehealth provisions critical to cancer patient care

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.

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About the American Cancer Society

The American Cancer Society is a leading cancer-fighting organization with a vision to end cancer as we know it, for everyone. For more than 100 years, we have been improving the lives of people with cancer and their families as the only organization combating cancer through advocacy, research, and patient support.  We are committed to ensuring everyone has an opportunity to prevent, detect, treat, and survive cancer. To learn more, visit cancer.org or call our 24/7 helpline at 1-800-227-2345. Connect with us on Facebook, Twitter, and Instagram.

About ACS CAN

The American Cancer Society Cancer Action Network (ACS CAN) makes cancer a top priority for policymakers at every level of government. ACS CAN empowers volunteers across the country to make their voices heard to influence evidence-based public policy change that improves the lives of people with cancer and their families. We believe everyone should have a fair and just opportunity to prevent, find, treat, and survive cancer. Since 2001, as the American Cancer Society’s nonprofit, nonpartisan advocacy affiliate, ACS CAN has successfully advocated for billions of dollars in cancer research funding, expanded access to quality affordable health care, and advanced proven tobacco control measures. We’re more determined than ever to stand together with our volunteers to end cancer as we know it, for everyone. Join the fight by visiting www.fightcancer.org.

 

For further information: American Cancer Society Action Network, Alissa.Crispino@cancer.org American Cancer Society, Michele.Money-Carson@cancer.org