HCPCS G0023
Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities: person-centered assessment, performed to better understand the individual context of the serious, high-risk condition. ++ conducting a person-centered assessment 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 separately billed). ++ facilitating patient-driven goal setting and establishing an action plan. ++ providing tailored support as needed to accomplish 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 coordination. ++ coordinating receipt of needed services from healthcare practitioners, providers, and facilities; home- and community-based service providers; and caregiver (if applicable). ++ communication with 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, functional deficits, goals, preferences, and desired outcomes, including cultural and linguistic factors. ++ coordination of care transitions between and among health care practitioners and settings, including transitions involving referral to other clinicians; follow-up after an emergency department visit; or follow-up after discharges from hospitals, skilled nursing facilities or other health care facilities. ++ 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. health care access / health system navigation. ++ helping the patient access healthcare, including identifying appropriate practitioners or providers for clinical care, and helping secure appointments with them. ++ providing the patient with information/resources to consider participation in clinical trials or clinical research as applicable. facilitating behavioral change as necessary for meeting diagnosis and treatment goals, including promoting patient motivation to participate in care and reach person-centered diagnosis or 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 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
Current code30 hospitals with prices
What Washington hospitals publish for this code
Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.
| Hospital | Medicare Advantage rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $115 – $127 | — | — |
| Deaconess Medical Center | $111 – $122 | — | — |
| Harborview Medical Center | $118 – $129 | $178 | $255 |
| Island Hospital | $121 – $129 | — | — |
| Kadlec Regional Medical Center | $113 – $136 | — | — |
| Legacy Salmon Creek Medical Center | $117 – $127 | $141 | $217 |
| Mary Bridge Children's Hospital | $116 – $128 | — | — |
| MultiCare Auburn Medical Center | $116 – $127 | — | — |
| MultiCare Covington Medical Center | $116 – $127 | — | — |
| MultiCare Good Samaritan Hospital | $116 – $128 | — | — |
| MultiCare Valley Hospital | $114 – $122 | — | — |
| Olympic Medical Center | $127 – $164 | — | — |
| Overlake Hospital Medical Center & Clinics | $118 – $123 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $113 – $136 | — | — |
| Providence Centralia Hospital | $118 – $188 | — | — |
| Providence Holy Family Hospital | $113 – $125 | — | — |
| Providence Regional Medical Center Everett | $116 – $127 | — | — |
| Providence St Mary Medical Center | $113 – $125 | — | — |
| Providence St Peter Hospital | $117 – $187 | — | — |
| Skagit Valley Hospital | $92.50 – $97.13 | $77.60 | $97.00 |
| Swedish Edmonds Hospital | $116 – $139 | — | — |
| Swedish Issaquah | $118 – $142 | — | — |
| Swedish Medical Center | $118 – $141 | — | — |
| Swedish Medical Center / Cherry Hill | $118 – $141 | — | — |
| Tacoma General Allenmore Hospital | $116 – $128 | — | — |
| University of Washington Medical Ctr | $118 – $129 | $149 | $213 |
| Virginia Mason Medical Center | $70.53 – $106 | — | — |
| Wellfound Behavioral Health Hospital | — | — | — |
| WhidbeyHealth Medical Center | — | $85.00 | $85.00 |
| Yakima Valley Memorial | $119 – $133 | $124 | $311 |
Medicare (traditional) reference
Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.
- Doctor's fee, Seattle (King County)
- $100 in an office; $47.64 in a hospital or surgery center
- Doctor's fee, rest of Washington
- $89.78 in an office; $44.76 in a hospital or surgery center
- Hospital outpatient payment (national)
- $104 (APC 5822)