Resources for care teams
By MySeema · Published November 10, 2026
A plain guide to PIN for physician practices, ACOs, and health systems: what it is, who qualifies, the codes, and what must be in place before you start.
Principal Illness Navigation (PIN) is a Medicare service that helps a patient with one serious, high-risk illness expected to last at least three months navigate their care under a disease-specific plan.
The PIN codes are G0023, G0024, G0140 and G0146.
| Code | Covers | 2026 national office benchmark |
|---|---|---|
| G0023 | Illness navigation: First 60 minutes / month | $87.18 / patient month |
| G0024 | Illness navigation: Each additional 30 minutes | $54.44 / additional 30 min |
| G0140 | Peer-support pathway: First 60 minutes / month | $89.18 / patient month |
| G0146 | Peer-support pathway: Each additional 30 minutes | $53.44 / additional 30 min |
PIN supports a qualifying serious, high-risk illness. Initiating-visit, consent, personnel and supervision requirements apply. General navigation and behavioral-health peer support are distinct pathways.
2026 Medicare allowed amounts, national office/nonfacility benchmark, non-QP conversion factor. Includes applicable patient cost sharing; before practice costs and MySeema fees. Actual collections vary with location, setting, clinician, coverage, and claim adjustments. See the rate source and estimate your practice.
Patient cost sharing and protections depend on coverage and the service. Explain them before consent. RHC/FQHC payment rules and Medicare Advantage contracts differ from the national benchmark.
Your clinicians keep clinical decisions and oversight, and your organization bills eligible services.
The benchmarks on this page are 2026 amounts. Medicare’s 2027 conversion factor is lower ($32.63 for most clinicians, down 2.31%), so 2027 payment amounts will differ. Read what the 2027 fee schedule changes.
No. Cancer is one possible example. PIN may fit other serious, high-risk illnesses when the condition and service meet current requirements and the practitioner establishes a disease-specific treatment plan.
General navigation may support many needs and funding arrangements. Medicare PIN is a defined practitioner-led service tied to one qualifying serious illness, an initiating visit, trained personnel, supervision, and documentation.
PIN centers on navigating a serious-illness care plan. CHI centers on specific social or practical barriers that materially interfere with diagnosis or treatment. The need and service requirements determine the fit.
This guide summarizes Medicare requirements for planning. It is not a billing manual or a promise of reimbursement. Confirm requirements with your billing and compliance teams.
Discuss the population and workflow you want to support, the responsibilities your team would retain, and the next steps for a proposed scope.