top of page

Medicare Moves Advance Health Equity, SDOH, and Coaching

Updated: Aug 11, 2023

In July 2023, Medicare shared their laudable mission informing proposed changes for 2024:

“If finalized, the proposals in this rule ensure the people we serve experience coordinated care focused on treating the whole person, considering each person’s unique story and individualized needs — physical health, behavioral health, oral health, social determinants of health, and are inclusive of caregivers, which are all so important to providing the care that people with Medicare deserve.” What Moves is Medicare proposing?

1. Coding and payment for social determinants of health risk assessments.

2. Separate coding and payment for community health integration services (supporting SDOH), including person-centered planning, health system coordination, promoting patient self-advocacy, and facilitating access to community-based resources to address unmet social needs.

3. Improve access to behavioral health in Medicare by allowing marriage and family therapists and mental health counselors, including addiction counselors, to enroll in Medicare and bill for their services for the first time. Increase payment for crisis care, substance use disorder treatment, and psychotherapy.

4. Payment for Principal Illness Navigation services to help patients navigate cancer treatment and treatment for other serious illnesses. These services are also designed to include care involving other peer support specialists, such as peer recovery coaches for individuals with substance use disorder.

5. Pay for certain caregiver training services in specified circumstances, so that practitioners are appropriately paid for engaging with caregivers to support people in carrying out their treatment plans.

6. Relevant to coaches – add health and well-being coaching services using the Category III coaching CPT codes, to the Medicare Telehealth Services List on a temporary basis for CY 2024.

While temporary, Medicare’s proposal to open the door to 2024 payment for health and well-being coaching services is a pivotal and promising move for our field, particularly in the context of better addressing health equity and SDOH. It’s time, time for more and more people to grow and thrive with our help as the best health and well-being coaches!

The Excited Wellcoaches Team

1,116 views0 comments


bottom of page