Understanding Principle Illness Navigation (PIN) Codes in Behavioral Health Organizations
Principle Illness Navigation (PIN) codes G0140 and G0146 released by CMS in 2024 are essential tools for Behavioral Health organizations to streamline patient care and improve outcomes. If your organization isn’t utilizing these codes, you may benefit from reviewing their use to see if they are right for your patient population’s ongoing support.
Key Points:
Purpose of PIN Codes: PIN codes are designed to help compensate organizations for ongoing support of patients in need by peer support specialists.
How PIN Codes Work: After an initial visit by a clinical psychologist billing CPT 90791, 96156, 96158, 96159, 96164, 96165, 96167 or 96168, the provider can then order PIN to be performed incident to under general supervision in an outpatient setting.
Peer Navigators: Peer navigators are individuals with lived experience of mental health conditions who provide support and guidance to patients. They play a crucial role in helping patients navigate the healthcare system, offering emotional support, and connecting them with necessary resources. Peer Navigators must certified and / or trained to perform the services.
Billing for Services: To bill for their services, peer navigators must work under the supervision of a licensed healthcare provider who can bill incident to services. HCPCS codes G0140 and G0146 for PIN-peer support services are utilized. These are time-based codes so documentation is crucial for billing and compliance. RHC and FQHCs are also able to bill for PIN utilizing G0511.
Benefits for Behavioral Health Organizations:
Enhanced Communication: PIN codes facilitate better communication among healthcare providers, making it easier to coordinate care for an oftentimes difficult population.
Reimbursement: The work of the Peer navigator is often done in the practice without reimbursement. Through the proper use of Peer Navigation, BH organizations may be better reimbursed for work they currently are not being paid for.
Implementation: To effectively use PIN codes, Behavioral Health organizations need to train their staff on the coding system and integrate it into their electronic health records (EHR) systems for better follow-up, care coordination and reporting.
By understanding and utilizing PIN codes and the support of peer navigators, Behavioral Health organizations can enhance the quality of care they provide, leading to better patient outcomes and more efficient operations. For assistance with how to implement a PIN program please reach out to us at info@viabilitycompany.com.