Principal Illness Navigation & Principal Care Management Codes 101

Discover the new Principal Illness Navigation (PIN) and Principal Care Management (PCM) codes, which now enable reimbursement for patient navigation services under Medicare. Dr. Morris will explain how these codes enhance care coordination for patients with serious or complex conditions, including cancer, and how community-based organizations and non-clinical navigators can participate through partnerships with billing providers. This session will also highlight training requirements, billing structures, and the broader movement toward equitable access to navigation services.

Learning Objectives:

1. Understand the structure and purpose of PIN and PCM codes as tools for reimbursing patient navigation and care management services under Medicare and other payers.
2. Learn how community-based organizations and non-clinical navigators can participate in delivering reimbursable services through partnerships with qualified billing providers.
3. Identify the training, supervision, and documentation requirements necessary to implement these codes effectively and ensure compliance with CMS and AMA guidelines.

About the Presenter:

Dr. Bonny Morris PhD, MSPH,RN

As Vice President of Navigation at the American Cancer Society, I lead the strategy, development, and implementation of navigation programs, including ACS CARES (Community Access to Resources, Education, and Support), ACS LION (Leadership in Oncology Navigation) and the Patient Navigation Initiative capacity-building grants. My program development and research focus on multi-level strategies integrating digital health and patient navigation to optimize cancer care delivery. The collective goal of this work is to increase equitable access to high quality cancer care by providing strategic patient navigation funding and ACS program support to overcome patient, provider, and system barriers.

I leverage my multidisciplinary background to view program development and research through the lens of a clinical team member and patient advocate, considering key system and provider-level factors; an epidemiologist, focusing on rigorous study design and analyses; and a social and behavioral scientist, acknowledging the importance of community-level social determinants of health and patient-level factors impacting the cancer experience.

CEU Information:

Board Certified Patient Advocates (BCPA):

This session is available for BCPA CEs (1 CE). This live Community Conversation will take place on Nov 10, 2025, and will also be made available on-demand. You must complete the follow-up CE Survey in order to obtain credit.

In order to receive your BCPA 1.0 CE credit as per PACB requirements, you must complete a post-assessment. Instructions for how to access the recording and assessment will be provided via email after completing registration. Certificates will be sent soon after the live event.

Approval Statement: HealthAdvocateX 'Principal Illness Navigation & Principal Care Management Codes 101' is approved for 1.0 General CE by the Patient Advocate Certification Board to satisfy the requirements for Board Certified Patient Advocates (BCPA).

This Continuing Education course is a live, virtual event hosted by HealthAdvocateX. It will take place on Nov 10, 2025. This event will be recorded and made available for on-demand CE credit. You must attend the live event or view the on-demand recording if you are interested in participating and/or obtaining BCPA CE credit.

If you have any questions, please email info@HealthAdvocateX.org