Geriatric Social Work Education Consortium
New CMS Rules Impacting Social Care Delivery
Last Updated August 11, 2023

There are times when discussions in Washington DC may impact how we provide social care in our communities. Now is one such time as the Centers for Medicare and Medicaid Services (CMS) are proposing coding and payment changes for addressing health-related social needs (HRSNs) and the overall effort to align health and social care ecosystems.

If you would like to learn more about this important discussion, you are invited to join us on Tuesday, August 22 from 1:30 to 3:00 p.m. ET for a free webinar, What Does the CY 2024 Medicare Physician Fee Schedule Proposed Rule Mean for Addressing HRSNs? This session will provide an overview and discussion of these updates along with your opportunity to participate in the public comment process.

All registrants will receive a copy of the webinar materials and recording, so if you are unable to attend live, please consider registering and joining us on-demand.

I have included additional information below if you are interested.

June Simmons President & CEO Partners in Care Foundation

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Additional Information and Resources about the Proposed Rule

Summary: As part of the proposed CY2024 Physician Fee Schedule, CMS is proposing coding and payment changes for services to address health-related social needs (HRSNs) through separate payments for Community Health Integration (CHI), SDOH Risk Assessment, and Principal Illness Navigation (PIN) services.

The proposed codes are the first that include community health workers, care navigators, and peer support specialists, and that allow these services to be provided by personnel employed by community-based organizations (CBOs) under the general supervision of the billing practitioner. Also included are changes to the payment mechanism for SDOH risk assessment activities—including allowing assessment as an optional additional element with additional payment during the annual wellness visit.

Other potentially significant updates for evaluation and management visits, telehealth services, outpatient diabetes self-management programs, and behavioral health services are included in the proposed rule.

Linked below are additional resources pertaining to the proposed rule. The Partnership will update stakeholders regarding upcoming opportunities to learn and discuss what the changes could mean when addressing HRSNs for Medicare fee-for-service populations.

NEW: Summary slides, CY2024 Physician Fee Schedule Proposed Rule Overview & Discussion Items, compiled by Tim McNeill, RN, MPH, CEO Freedmen’s Health (Updated August 8)

Comments about this proposed rule are due by September 11.