Principal Illness Navigation Software for Billing and Documentation
Turn Care Coordination Into Billable Revenue
Schedule Your Revenue Opportunity Assessment
Your team is already coordinating specialists, helping patients overcome barriers to care, and documenting critical interactions. Clinii works alongside your existing EHR to help capture qualifying Principal Illness Navigation activity, generate billing-ready documentation, and improve reimbursement visibility without adding staff or replacing the systems your team already uses.
Supports G0023 and G0024
Integrates With 25 EHRs
AI-Powered Documentation
One Workflow for Principal Illness Navigation
Clinii supports the PIN workflow from patient eligibility through billing-ready documentation:
Instead of relying on spreadsheets, disconnected tools, or month-end reconstruction, Clinii helps organize qualifying activity within the workflows your team already uses. Agentic AI supports documentation as care coordination happens, helping organizations expand PIN services while reducing administrative burden.
- STEP 1 Identify potentially eligible patients
- STEP 2 Document the initiating visit and patient consent
- STEP 3 Complete the person-centered assessment
- STEP 4 Create the person-centered action plan
- STEP 5 Capture qualifying navigation activities and time
- STEP 6 Monitor monthly progress and documentation gaps
- RESULT Generate billing-ready documentation
What Is Principal Illness Navigation
Principal Illness Navigation, or PIN, is a Medicare-covered service for patients with a serious, high-risk condition expected to last at least three months. PIN supports patients as they navigate treatment, coordinate services, access community resources, and address barriers that may interfere with the practitioner’s treatment plan.
Qualified auxiliary personnel, including trained patient navigators, may deliver PIN services under the general supervision of the billing physician or other qualified healthcare practitioner. Standard PIN services are billed monthly under HCPCS codes G0023 and G0024. Separate peer-support codes, G0140 and G0146, apply to qualifying services furnished by trained peer-support personnel for serious, high-risk behavioral health conditions.
The Operational Gap Behind Missed PIN Revenue
Many healthcare organizations already perform activities that align with Principal Illness Navigation. The challenge is consistently identifying eligible patients, documenting consent and required activities, tracking qualifying time, and connecting the work to billing-ready records. When these steps depend on manual entry or retrospective review, reimbursable activity may be missed.
Clinii provides an operational layer alongside the EHR to help teams capture qualifying activity, monitor documentation requirements throughout the month, and prepare billing-ready output. As patient navigation software built for operational and billing visibility, Clinii helps teams see what has been completed, what is missing, and what may be ready to bill.
How Clinii Supports PIN Requirements
Eligibility and enrollment
Helps teams identify potentially eligible patients and organize enrollment, initiating-visit, and consent information.
Person-centered assessment and action plan
Clinii Web provides a workspace alongside the EHR for assessments, action plans, and program requirements.
Activity and time documentation
CareLink helps capture qualifying activity across supported EHR, phone, and browser workflows and associate documented time with the appropriate service.
Patient communication and support
Connect-AI helps convert supported calls, messages, and outreach into notes, tasks, and documented activity.
Navigation across care settings
Clinii Clinician supports documentation from the field, bedside, or between facilities.
Monthly monitoring
Mid-month visibility helps teams see completed activity, missing requirements, and progress toward billing thresholds.
Billing-ready records
Clinii organizes time logs, action-plan activity, patient contacts, and supporting documentation for billing review.
Manual PIN Documentation Compared With Clinii
Manual PIN workflows can require spreadsheets, duplicate documentation, and end-of-month reconstruction. Clinii helps reduce those manual processes so care teams can focus on patient navigation while operations leaders maintain visibility into documentation and reimbursement readiness.
Manual Process
With Clinii
Manual time tracking
Activity and time capture within supported workflows
Month-end reconstruction
Documentation created as supported activity occurs
Missed qualifying interactions
Greater visibility into documented qualifying interactions
Disconnected systems
One operational workflow alongside the EHR
Limited program visibility
Mid-month documentation and progress visibility
Records assembled after the fact
Records organized continuously to support audit readiness
Who Delivers PIN and Who Bills It
PIN services may be delivered by qualified auxiliary personnel under the general supervision of the billing physician or other qualified healthcare practitioner. The billing practitioner reports the service after the applicable requirements are met. Because the navigator performing the work and the practitioner billing for it may be different people, organizations need a reliable way to connect each qualifying interaction, documented minute, and required record.
Clinii helps connect supported navigation activity to the patient record, action plan, and billing workflow so teams can review complete documentation before claims are submitted.
Principal Illness Navigation Billing Codes
Payment amounts and payer policies may change. Confirm current coverage and billing requirements before submitting claims.
HCPCS Code
G0023
Initial 60 minutes of standard Principal Illness Navigation services during a calendar month.
Learn MoreHCPCS Code
G0024
Each additional 30 minutes of standard PIN services during the same calendar month. Reported with G0023.
Learn MoreHCPCS Code
G0140
Initial 60 minutes of Principal Illness Navigation peer-support services during a calendar month.
HCPCS Code
G0146
Each additional 30 minutes of PIN peer-support services during the same calendar month. Reported with G0140.
PIN Alongside Other Medicare Care Programs
PIN may be furnished in the same month as another Medicare care management service when the requirements for each service are independently met. The same time and work cannot be counted toward more than one billed service. Clinii gives organizations one place to manage documentation across PIN and other supported programs, helping teams distinguish activities and reduce the risk of duplicate time.
Why Choose Clinii
- Use the care team and EHR workflows already in place
- Help identify potentially eligible patients and organize enrollment requirements
- Reduce manual time tracking and month-end reconstruction
- Use agentic AI to support documentation within everyday workflows
- Monitor progress and documentation gaps before month-end
- Prepare organized, billing-ready records
- Manage PIN alongside multiple Medicare care programs
- Work alongside 25 EHRs without replacing the existing system
Built to Improve PIN Performance
Clinii helps healthcare organizations turn qualifying care coordination into documented, billing-ready activity without increasing administrative burden. Operations and care management leaders gain greater visibility across eligibility, documentation, monthly progress, and reimbursement readiness while care teams continue working within familiar systems.
- CareLink
- EHR Integrations
- athenahealth Integration
- Patient Eligibility and Revenue Opportunity Assessment
Frequently Asked Questions
What is Principal Illness Navigation?
Principal Illness Navigation is a Medicare-covered service for patients with a serious, high-risk condition. It supports patient navigation, care coordination, access to resources, health-system navigation, and other qualifying activities connected to the practitioner’s treatment plan.
Who may provide and bill PIN services?
Qualified auxiliary personnel, including trained patient navigators, may provide PIN services under the general supervision of the billing physician or other qualified healthcare practitioner. The billing practitioner reports the service after the applicable requirements are met.
What patients may qualify for PIN?
PIN is intended for patients with a serious, high-risk condition expected to last at least three months and place the patient at significant risk of hospitalization, nursing-home placement, acute exacerbation or decompensation, functional decline, or death. Eligibility and coverage should be verified for each patient.
Does PIN require an initiating visit and patient consent?
Yes. PIN generally requires an eligible initiating visit by the billing practitioner. Patient consent must be documented in the medical record, and the patient should be informed that applicable Medicare cost-sharing may apply.
What must be documented for PIN billing?
Documentation should include the patient’s consent, qualifying condition, person-centered assessment and action plan, the amount of time spent, the nature of the activities performed, and how those activities relate to the treatment plan. Applicable supervision and personnel requirements must also be met.
How does Clinii support PIN documentation?
Clinii helps capture supported navigation activities and time, monitors monthly requirements, and organizes billing-ready documentation alongside the EHR workflow your team already uses.
Can PIN be provided with CCM, PCM, or another Medicare service?
PIN may be reported in the same month as another care management service when the requirements for each service are independently met. The same time and work cannot be counted toward more than one service.
What is the difference between standard PIN and PIN peer support?
Standard PIN codes G0023 and G0024 cover qualifying navigation services furnished by trained auxiliary personnel. G0140 and G0146 cover qualifying peer-support services for patients with serious, high-risk behavioral health conditions and require appropriately trained peer-support personnel.
See the Revenue Opportunity in Your Principal Illness Navigation Program
Clinii can help your organization identify potential PIN opportunities, strengthen documentation workflows, and understand where qualifying activity may be going uncaptured.
