This toolkit supports organizations to bill for community health workers/promotores (CHW/P) interventions.
CHWs/Ps are increasingly seen as important members of the health care workforce. They are trained professionals, often members of the community they serve, who support people in navigating the health and social services systems with a focus on addressing health-related social needs. As health care shifts toward value-based care payment models, organizations that provide CHW/P interventions to patients can receive reimbursement through a variety of mechanisms.
About This Tool
This comprehensive toolkit provides information and resources to help organizations establish capacity to bill for CHW/P interventions. Chapters provide a range of practical information, including explanations of how reimbursement works and descriptions of tools that can be used to bill for CHW/P services. Examples of resources include:
- An overview of coding and billing for medical services that could be delivered by a CHW/P in health care settings.
- Opportunities to provide CHW/P services reimbursed through managed care organizations.
- Strategies for negotiating contracts and payment rates with health payers to fund CHW/P interventions.
Providers and organizations that offer CHW/P interventions can use this toolkit to learn more about reimbursement for services provided by CHWs/Ps.