PIN Software & Services
Principal Illness Navigation (PIN) Software and Services
Principal Illness Navigation is a Medicare-covered service that helps patients with a serious, high-risk illness manage the practical side of their care — scheduling, medications, benefits, transportation and the barriers that cause people to miss treatment. HealthArc gives navigators one place to enroll eligible patients, log time against the right codes, document consent, and hand clinicians a clean record every month.
HIPAA Compliant
AICPA SOC 2 Certified
Medicare-covered since CY2024
Consent loggedwith initiating visit
G0023 / G0024Patient navigation — first 60 min + each additional 30 min
G0140 / G0146Peer support — first 60 min + each additional 30 min
Overlap checksFlags patients already enrolled in CCM, PCM or TCM
2,000+Providers on HealthArc
45+States Covered
2024Year Medicare began paying for PIN
4 codesG0023, G0024, G0140, G0146
Program Overview
What Is Principal Illness Navigation?
PIN is a care management service built around one serious condition rather than a patient’s entire chart. A trained navigator or certified peer specialist works with the patient by phone, by message, and in person to remove obstacles between them and their treatment plan.
The Centers for Medicare & Medicaid Services (CMS) created PIN in the Calendar Year 2024 Physician Fee Schedule to pay for navigation work that clinics were already doing without reimbursement. Both are billed monthly and based on the time your team spends with the patient.
Patient navigation — G0023 / G0024
Delivered by a trained navigator for a serious high-risk illness.
Peer support — G0140 / G0146
Delivered by a certified peer specialist with lived experience, for behavioral health and substance use conditions.
If you already run Remote Patient Monitoring, Chronic Care Management, or Behavioral Health Integration with HealthArc, PIN uses the same workflow and the same care team.
Eligibility
Who Qualifies for PIN Services?
A patient is eligible when they have a serious, high-risk condition that a clinician expects to last at least three months and that puts them at risk of hospitalization, physical or mental decline, or death. Cancer is the common example, though the definition covers many serious diagnoses. The peer-support track is meant for behavioral health and substance use conditions.
One practitioner bills PIN for a given patient in a given month. If another team already manages that patient under a service like CCM or PCM, the time and codes cannot overlap.
Before navigation time can count
- An initiating visit — an E/M visit or Annual Wellness Visit with the billing practitioner that establishes the condition and introduces PIN.
- Consent — the patient agrees to receive the service. Consent can be verbal, but it has to be documented, and the patient should be told that normal Medicare cost-sharing applies.
Billing & Reimbursement
PIN CPT and HCPCS Codes
Medicare pays for PIN under four HCPCS codes. The base codes cover the first 60 minutes in a month; the add-on codes cover each additional 30 minutes. HealthArc's platform totals monthly minutes so you know when a claim is ready.
Base
G0023
PIN, base service
First 60 min / month
Delivered by a trained navigator under general supervision.
Add-on
G0024
PIN, add-on to G0023
Each additional 30 min
Billed together with G0023.
Base
G0140
PIN Peer Support, base service
First 60 min / month
Delivered by a certified peer specialist.
Add-on
G0146
PIN Peer Support, add-on to G0140
Each additional 30 min
Billed together with G0140.
Payment rates change every year with the Medicare conversion factor. Confirm current national payment amounts via the CMS Physician Fee Schedule Look-Up Tool before quoting figures to patients.
The Platform
How HealthArc Supports Your PIN Program
This page is for practices, health systems, and care-management teams that want to launch a PIN program and bill for it correctly.
Eligibility & Enrollment
Flag patients with qualifying diagnoses from the EHR, and track consent and the initiating visit in one record.
Time Tracking Tied to Codes
Navigators log activities against G0023/G0024 or G0140/G0146, and the platform totals monthly minutes so you know when a claim is ready and when time crosses into an add-on.
Overlap Checks
See when a patient is already enrolled in CCM, PCM, TCM, or another time-based service, so your team does not count the same minutes twice.
Documentation & Audit Trail
Consent, care activities, and time stamps stay attached to the patient for billing and audits.
How It Compares
PIN vs. CCM and PCM
PIN often gets confused with Chronic Care Management (CCM) and Principal Care Management (PCM). The difference is scope and who does the work. A patient can be enrolled in more than one program, but your team cannot count the same minutes twice.
CCM
Chronic Care Management
Two or more chronic conditions across the patient’s whole care picture.
PCM
Principal Care Management
One high-risk condition, usually clinical management by a care team.
PIN
Principal Illness Navigation
One serious illness, but the work is navigation and support: coordinating appointments, connecting patients to resources, and clearing practical and social barriers — often through non-clinical navigators or peer specialists.
Already running CCM? See 10 Best Chronic Care Management Software Platforms in 2026 for how CCM platforms compare.
Getting Started
Getting Started with PIN
Launching PIN usually takes three steps. HealthArc’s onboarding team helps you map qualifying diagnoses, configure consent capture, and connect the program to your EHR.
1
Identify Eligible Patients
Find patients in your existing panel with a qualifying serious, high-risk condition.
2
Train Navigators or Peer Specialists
Bring on trained patient navigators for G0023/G0024, or certified peer specialists for G0140/G0146.
3
Set Your Monthly Routine
Establish documentation and billing cadence, connected to your EHR through HealthArc.
FAQ
Frequently Asked Questions
Answers to the questions practices most commonly ask when evaluating PIN programs.
Is Principal Illness Navigation covered by Medicare?
Yes. Medicare began paying for PIN in 2024 under HCPCS codes G0023, G0024, G0140, and G0146. Standard Part B cost-sharing applies, so patients may owe coinsurance unless they have supplemental coverage.
Who can deliver PIN services?
Trained patient navigators deliver the standard service (G0023/G0024) under the general supervision of the billing practitioner. Certified peer specialists deliver the peer-support version (G0140/G0146) for behavioral health and substance use conditions. CMS does not require a single national certification, but it expects staff to be trained and competent for the role.
Can a patient get PIN and Chronic Care Management in the same month?
Yes, if the services are distinct and your team does not count the same time under both. The care activities and minutes billed under PIN have to be separate from those billed under CCM, PCM, or other time-based services.
Does PIN require patient consent?
Yes. The patient has to consent before services begin. Consent can be verbal, but you must document it and tell the patient that Medicare cost-sharing applies. Only one practitioner can bill PIN for that patient per month.
What conditions qualify for PIN?
Any serious, high-risk condition a clinician expects to last at least three months and that risks hospitalization, decline, or death. Cancer is the most cited example. The peer-support track is designed for behavioral health conditions, including substance use disorders.
Ready to Run PIN?
See HealthArc’s PIN Platform in Action
- Principal Illness Navigation pays your team for work you may already be doing
- How eligibility, consent, and the initiating visit are tracked in one record
- How navigator and peer-support time maps to G0023, G0024, G0140, and G0146
- How overlap with CCM, PCM, and other programs is prevented
Schedule a Demo
HIPAA Compliant • SOC 2 Certified • No long-term contracts
sales@healtharc.io • +1-201-885-5571
sales@healtharc.io • +1-201-885-5571
How can HealthArc help you?
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Resources
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