02/17/2025

Billing for Navigation Services

The significance of billing for navigation services was a topic of discussion at the 2024 Academy of Oncology Nurse and Patient Navigators (AONN) Midyear Conference. Presenter Danielle Brown, MBA, BSN, RN, OCN, CN-BN, described the importance of billing for navigation services and provided examples.

She stated, “We have about 90 to 100 community practices across the state of Florida, and a large group of nurses were using the Oncology Care Model (OCM) to offer navigation services. There were some reimbursements coming through the Monthly Enhanced Oncology Services (MEOS) payments through that model. When the OCM ended, it led to a loss of revenue for many practices across the nation.”

Nevertheless, despite the lack of revenue, there remained an excess of nurses offering navigation services, as providing guidance to patients is of utmost importance.

“Continuing navigation is the right thing to do whether or not there is reimbursement; it is the right thing to do for our patients,” she said.

In response to this loss of revenue, nurse assignments shifted, and there was a refocus of efforts after the OCM ended. This example highlights the significance of invoicing for navigation services. It is also crucial to bill for navigation to offset the expenses of employing full-time staff, investing in technology upgrades, and supporting value-based healthcare.

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