Reimbursement for Cancer Navigation Services

CMS has made a historic decision to commence reimbursement for cancer navigation services. Jasper Health delivers virtual cancer navigation and supportive care services to improve the lives of people living with cancer.

Jasper Health was founded on the commitment to deliver high-quality virtual navigation and supportive care to individuals affected by cancer. With unprecedented rates of provider burnout and health system budget cuts, Jasper Health offers a new model for connecting individuals affected by cancer with a dedicated Care Navigator. We believe cancer navigation is more than a cost reductions strategy, it is a holistic approach to helping patients and caregivers navigate a complex and fragmented system.

What is Cancer Navigation?

Full Services Solution: High-touch Wrap-around navigation for patients
Jasper’s specialty-trained Care Navigators are matched directly with individuals affected by cancer to provide one-on-one empathetic guidance and resources specific to their needs.

Technology: Cancer Care Navigation Platform for Navigators and Supportive Care Professionals
We are licensing our AI-driven Cancer Care Management Platform directly to our partners that can be fully-white labeled and deeply customized. Now nurses, social workers, care managers and other supportive care professionals can better coordinate care, build self-advocacy skills, hone personal goals, help avoid unnecessary hospital visits, and reduce frustration with the fragmented reality of healthcare in this country.

What are the new codes and how will they impact this space?

Key PINS CPT codes for reimbursement include:

  • CPT Code G0023:
  • Principal Illness Navigation Services — additional 60 minutes per calendar month.
  • CPT Code G0024:
  • Principal Illness Navigation Services — additional 30 minutes per calendar month.

Comprehensive Care:
A new SDOH Risk Assessment Code:

  • CPT Code G0136
  • Emphasizes a holistic approach to care, covering Social Determinants of Health.

Peer Support:

  • CPT Codes G0140 and G0146
  • Designed specifically for PIN services provided by peer support around behavioral health conditions.
  • CPT Code G2211
  • An add-on code, highlights the importance of the long-term relationship between practitioners and patients.

These codes will truly enable cancer care navigation and care unlike anytime in history. The key for organizations is to be ready 1/1/2024 to leverage the codes and provide life saving services for cancer patients & caregivers. Jasper can help with that!

Benefits to Healthcare Providers: 

With Jasper, clinics, health systems, and care management teams can now offer high-touch, wrap-around Navigation services with 24/7 support to complement patient’s clinical cancer care.  For the last two years, Jasper has been scaling the technology and supportive care resources to provide Cancer Care Navigation under a PMPM model for health plans and employers; with this Reimbursable Cancer Care Navigation Solution, we are extending these benefits to healthcare providers. Benefits include:

✅ High patient satisfaction and engagement 

✅ Success with value-based care 

✅ Staffing Efficiency Gains

✅ New Revenue Streams 

Key Differentiator of Jasper’s Cancer Care Navigation Platform

➕AI ASSISTED: Advanced AI chat assistance to navigators and care managers, enabling them to efficiently provide guidance to patients at scale and matching patients to relevant resources such as copay assistance and medication support programs 

➕SEAMLESS ONCOLOGY-SPECIFIC TOOLSET: Consolidates documentation and omnichannel messaging into a unified toolset for seamless member collaboration and highly personalized engagement 

➕INTEROPERABILITY: Empowers clinical teams with configurability to match their workflows and compliance requirements in an HL7 FHIR standard compliant architecture for bi-directional health data interoperability.

➕MODULAR ARCHITECTURE: Offers modular configuration, enabling B2B partners to easily customize features as partnerships expand 

➕FULLY WHITE-LABELED: Jasper’s platform can be fully white labeled by partner brand and content for seamless patient experience

Jasper Health improves the cancer care experience

Mitigate unnecessary ED visits
of members would consult Jasper before using the ER*
Better medication adherence
of members report increased ease of medication plan adherence*
Improved employee satisfaction
of members report satisfaction with Jasper Care Navigators*

*Jasper member survey Oct 2023; among members who receive Jasper as a covered benefit.

Jasper’s 80+ Local and National Non Profit Partner Network provide resources that cover SDOH gaps

“We are at the forefront of a transformative era in oncology care, where the dedication of patient navigators is rightfully acknowledged. This decision by Medicare reflects a commitment to enhancing patient care and outcomes. We eagerly anticipate the positive ripple effects this will have on cancer patient experiences nationwide. ”
— Holly Spinks, Chief Clinical Officer