PYA has released a white paper, “Providing and Billing Medicare for SDOH-Related Services,” to help healthcare leaders leverage new Medicare reimbursement for addressing social determinants of health (SDOH).

In an easy-to-follow Q&A format, the white paper explains in detail the Centers for Medicare & Medicaid Services (CMS) billing rules for new services defined in the 2024 Medicare Physician Fee Schedule Final Rule:

  • SDOH risk assessments
  • Community Health Integration (CHI) services
  • Principal Illness Navigation (PIN) services

For each of the services, the white paper details beneficiary eligibility, provider qualifications, service elements, proper documentation, billing procedures, and Medicare reimbursement rates. 

This practical “how-to” manual provides critical instructions for providers seeking to capture reimbursement for the time and effort devoted to addressing patients’ SDOHs. It is similar in format and content to PYA’s widely-read white papers on care management services and remote patient monitoring.

PYA has supported healthcare organizations for more than 40 years. The PYA team helps clients understand and apply CMS rules and regulations and advises on other matters involving compliance, valuation, strategy, and transactions.

View White Paper

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