Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a
certified peer specialist; 60 minutes per calendar month, in the following
activities: person-centered interview, performed to better understand the
individual context of the serious, high-risk condition. ++ conducting a
person-centered interview to understand the patient's life story, strengths,
needs, goals, preferences, and desired outcomes, including understanding
cultural and linguistic factors, and including unmet sdoh needs (that are not
billed separately). ++ facilitating patient-driven goal setting and
establishing an action plan. ++ providing tailored support as needed to
accomplish the person-centered goals in the practitioner's treatment plan.
identifying or referring patient (and caregiver or family, if applicable) to
appropriate supportive services. practitioner, home, and community-based care
communication. ++ assist the patient in communicating with their practitioners,
home-, and community-based service providers, hospitals, and skilled nursing
facilities (or other health care facilities) regarding the patient's
psychosocial strengths and needs, goals, preferences, and desired outcomes,
including cultural and linguistic factors. ++ facilitating access to
community-based social services (e.g., housing, utilities, transportation, food
assistance) as needed to address sdoh need(s). health education. helping the
patient contextualize health education provided by the patient's treatment team
with the patient's individual needs, goals, preferences, and sdoh need(s), and
educating the patient (and caregiver if applicable) on how to best participate
in medical decision-making. building patient self-advocacy skills, so that the
patient can interact with members of the health care team and related
community-based services (as needed), in ways that are more likely to promote
personalized and effective treatment of their condition. developing and
proposing strategies to help meet person-centered treatment goals and
supporting the patient in using chosen strategies to reach person-centered
treatment goals. facilitating and providing social and emotional support to
help the patient cope with the condition, sdoh need(s), and adjust daily
routines to better meet person-centered diagnosis and treatment goals. leverage
knowledge of the serious, high-risk condition and/or lived experience when
applicable to provide support, mentorship, or inspiration to meet treatment
goals
Code effective Jan 01, 2024
HCPCS Section
Procedures/Professional Services (Temporary Codes)
G0140 is a valid 2026 HCPCS code meaning Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities: person-centered interview, performed to better understand the individual context of the serious, high-risk condition. ++ conducting a person-centered interview to understand the patient's life story, strengths, needs, goals, preferences, and desired outcomes, including understanding cultural and linguistic factors, and including unmet sdoh needs (that are not billed separately). ++ facilitating patient-driven goal setting and establishing an action plan. ++ providing tailored support as needed to accomplish the person-centered goals in the practitioner's treatment plan. identifying or referring patient (and caregiver or family, if applicable) to appropriate supportive services. practitioner, home, and community-based care communication. ++ assist the patient in communicating with their practitioners, home-, and community-based service providers, hospitals, and skilled nursing facilities (or other health care facilities) regarding the patient's psychosocial strengths and needs, goals, preferences, and desired outcomes, including cultural and linguistic factors. ++ facilitating access to community-based social services (e.g., housing, utilities, transportation, food assistance) as needed to address sdoh need(s). health education. helping the patient contextualize health education provided by the patient's treatment team with the patient's individual needs, goals, preferences, and sdoh need(s), and educating the patient (and caregiver if applicable) on how to best participate in medical decision-making. building patient self-advocacy skills, so that the patient can interact with members of the health care team and related community-based services (as needed), in ways that are more likely to promote personalized and effective treatment of their condition. developing and proposing strategies to help meet person-centered treatment goals and supporting the patient in using chosen strategies to reach person-centered treatment goals. facilitating and providing social and emotional support to help the patient cope with the condition, sdoh need(s), and adjust daily routines to better meet person-centered diagnosis and treatment goals. leverage knowledge of the serious, high-risk condition and/or lived experience when applicable to provide support, mentorship, or inspiration to meet treatment goals or (Nav srv peer sup 60 min pr m) for short. HCPCS G0140 has been effective since 01/01/2024 and applies to Medical care.
|
HCPCS Level II Code Section G - Procedures/Professional Services (Temporary Codes) |
|
| HCPCS Code | G0140 |
|---|---|
| Description |
Long description:
Short description: |
| HCPCS Pricing indicator |
13 - Clinical Lab Fee Schedule - Price established by carriers (e.g., not otherwise classified, individual determination, carrier discretion)
|
| Multiple pricing indicator |
A - Not applicable as HCPCS priced under one methodology
|
| Coverage code | C - Carrier judgment |
| BETOS2 code | M5D - Specialist - other |
| HCPCS Action code | N - No maintenance for this code |
| Type of service | 1 - Medical care |
| Effective date | Effective Jan 01, 2024 |
| Date added | Added Jan 01, 2024 |
1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).
2 BETOS stands for “Berenson-Eggers Type Of Service”
HCPCS Level II codes and descriptors are approved and maintained jointly by the alpha-numeric editorial panel (consisting of CMS, the Health Insurance Association of America, and the Blue Cross and Blue Shield Association). — Updated 7/13/2026
CPT® is a registered trademark of the American Medical Association (AMA). All rights reserved.