Bill for patient navigation
Principal illness navigation services
One Care Advocate guides each patient through one serious illness. Your practice bills it.
- No new hires. We run outreach, consent and monthly calls.
- One file a month. Nothing is billed until you approve it.
- $0 upfront. Works with your EHR, live in about a week.
$87.18* per patient, per month*PIN first 60 minutes (G0023), 2026 national rate
Get your PIN Plan
Works nationwide
Practices nationwide
You bill under your own NPI
Same Care Advocate every month
RNs, NPs, LCSWs and care companions
Monthly file approved by your team
No new hires needed
One Care AdvocateSame person, every month
Your NPI, your claimYou bill Medicare directly
Monthly billing fileYour team approves it
No upfront cost to the practice. Your team refers, we handle enrollment, outreach and documentation, and you bill Medicare under your own license. We connect with your EHR in about one week, and have worked with eClinicalWorks, Tebra and athenahealth.
Which patients qualify for PIN
Three conditions, all required. Your practitioner decides who is referred.
One serious, high-risk condition
Expected to last three months or more, with significant risk of hospitalization, nursing home placement, acute exacerbation or decompensation, functional decline or death.
An initiating visit
An E/M visit, not 99211, personally performed by the billing practitioner. It names the condition and the need for navigation.
Consent, renewed yearly
Verbal or written, given before or as services begin and again every year. CCM and CHI need consent only once.
| PIN requirement | Your practice | Companian |
|---|---|---|
| Initiating visit | Your practitioner performs it | Begins outreach once you approve the patient |
| Consent | Keeps the record on file | Explains PIN and its cost-sharing, documents consent and asks again before the year is up |
| Condition training | Agrees in the services agreement whose time counts | Team members named in that agreement, with training on the condition as CMS requires |
| Supervision | General supervision by the billing practitioner | Works under it, on the terms of the agreement |
| 60 minutes in the month | Approves the monthly file | Times each activity as it happens |
| The claim | Bills G0023 and G0024 and receives the payment | Never bills Medicare |
What 60 high-risk patients bring in each month
2026 Medicare-allowed amounts, and the diagnosis codes that qualify.
Example panel
$5,231 / month
$62,770 a year · 60 patients × $87.18 (G0023, national)
- G0023 pays $87.18 for the first 60 minutes nationally (2026).
- G0024 adds each further 30 minutes.
- PIN needs an initiating visit and one high-risk condition.
| Condition | ICD-10 examples | Program fit |
|---|---|---|
| Cancer in active treatment | e.g. C50.919 | PIN (G0023) |
| Dementia | e.g. G30.9 | PIN (G0023) |
| Advanced heart failure | e.g. I50.22 | PIN (G0023) |
| End-stage kidney disease, pre-dialysis | e.g. N18.5 | PIN (G0023) |
What a Care Advocate does each month
Practical help with your practitioner’s plan. Clinical decisions stay with your clinicians.
Explains the treatment plan
What the care team said, what comes next and why, in plain words. Health education the patient can act on.
Confirms visits and tests
Specialist visits, imaging and labs on the plan. A missed one is flagged to your office.
Routes anything new
A new symptom, a medication question or a change at home goes to your clinicians. The Care Advocate records it and does not decide.
Records every minute
Each call and activity is logged with its minutes. Gloria, our AI assistant, drafts the notes and a pre-visit summary; people make the calls.
Who makes the calls
Our care team is registered nurses, nurse practitioners, licensed clinical social workers and care companions, all remote. Your services agreement names who furnishes PIN, each trained on the condition.
When the illness changes
PIN covers one serious condition. Once it stabilizes, your practitioner may move the patient to principal care management, or to CCM if two or more chronic conditions drive care. The Care Advocate stays the same.
What PIN pays in 2026
National 2026 rates for each PIN code.
| Code | Service | National 2026 |
|---|---|---|
| G0023 | PIN, first 60 minutes in the calendar month | $87.18 |
| G0024 | PIN, each additional 30 minutes | $54.44 |
Which rate your practice gets
Medicare pays by payment locality, set by state and county: 109 localities nationwide. For CPT 99490 the 2026 amount runs from $60.71 in Arkansas to $83.76 in Alaska.
A 60-minute floor
G0023 covers the first 60 minutes a month, three times the 20 of CCM code 99490. Confirm with your Medicare contractor how a shorter month is handled. The monthly file shows minutes by activity before you approve. See the PIN code guide for worked examples.
On top of other care management
CMS lets PIN run alongside other care management when no time is counted twice. The file assigns each minute to one program, so a patient on chronic care management can get both in a month.
How PIN starts in your practice
Your staff refers, approves and reviews. The navigation in between is ours.
Initiating visit
Your practitioner sees the patient, names the serious condition and notes that navigation is needed.
Referral
Your team sends the patient to us by EHR access or the short referral form.
Approval and consent
You approve outreach once. The Care Advocate calls, explains PIN and the Part B cost-sharing, and documents consent.
Month-end file
One line per patient: program, codes, month, minutes by activity, activities and consent date. Approve it, then bill.
Questions about principal illness navigation services
Can principal illness navigation be done remotely?
Yes. CMS allows PIN in facility and non-facility settings and by telecommunications technology. Companian’s care team works fully remote, by phone and video.
Who can deliver PIN?
Trained auxiliary personnel, such as community health workers and patient navigators, under the billing practitioner’s general supervision. Your services agreement sets the terms; confirm them with your counsel.
How frequently can we bill PIN?
Once per practitioner per month for each serious, high-risk condition, with G0024 added for each 30 minutes past the first 60.
Can PIN and CHI be billed for the same patient?
Yes, when time and effort are not counted more than once. CHI addresses a social barrier such as transport or food; see community health integration.
Can our therapists bill PIN themselves?
Yes, from 2026. Marriage and family therapists and mental health counselors can bill PIN directly for mental illness services they perform. See the CY 2026 Physician Fee Schedule final rule (CMS-1832-F).
Is there a peer support version?
Yes. PIN delivered by peer support specialists who meet SAMHSA standards is billed with G0140 and G0146. This page covers G0023 and G0024.
What does the patient pay?
The Medicare Part B deductible and coinsurance on each code. The Care Advocate explains this on the consent call, before any time is billed.
How is Companian paid?
Your practice bills Medicare and receives the payment. Companian’s fee is set in the services agreement and walked through on the intro call.
Rates & disclosures
National amounts are 2026 Medicare Physician Fee Schedule non-facility payments at the non-QP conversion factor of $33.4009, computed from CMS RVUs. Your amount depends on your Medicare payment locality; see it in the CCM/PCM revenue calculator. Actual payment depends on participation status, place of service and cost-sharing.
Companian supplies Care Advocates and documentation to physician practices nationwide. Companian is not a medical practice and does not bill Medicare. The billing practitioner keeps the care plan, every clinical decision and the claim. Patients pay the usual Medicare Part B deductible and coinsurance for these services unless other coverage pays it.
Add navigation for your seriously ill patients
Fifteen minutes on your patient mix and where PIN fits. No patient information needed.