SDOH reporting to CMS mandatory in the inpatient sphere starting January 2024 (2024)

FAQs

Which SDOH is required by CMS in 2024? ›

1, 2024, the Centers for Medicare and Medicaid Services (CMS) began requiring healthcare organizations to screen for five social risk drivers, a task that was voluntary in 2023. The required five SDOH domains are: food insecurity, interpersonal safety, housing insecurity, transportation insecurity, and utilities.

Beginning in 2024, the Centers for Medicare & Medicaid Services (CMS) finalized a new Healthcare Common Procedure Coding System (HCPCS) code G0136 to pay for administering an SDOH risk assessment.

Beginning January 1, 2024, CMS is finalizing implementation of a separate add-on payment for healthcare common procedure coding system (HCPCS) code G2211. This add-on code will better recognize the resource costs associated with evaluation and management visits for primary care and longitudinal care.

The term "Health-Related Social Needs" is sometimes used interchangeably with the Social Determinants of Health (SDOH), but an important distinction can be made. HRSN refers to the social and economic needs that individuals experience that affect their ability to maintain their health and well-being.

Z63 (other problems related to primary support group) was the most documented SDOH-related Z code among patients with commercial insurance (62.75%–64.96% of all SDOH-related Z code encounters in 2018–2020) and Medicare Supplement (50.78%–55.09% of all SDOH-related Z code encounters in 2018–2020), whereas Z59 (problems ...

SDOH screening tools ask about various topics such as finances, family and community support, education, physical activity, substance use, mental health, and disabilities.

What is a social determinants of health screening tool? SDOH screening tools are surveys or questionnaires that you fill out before meeting with a healthcare provider. For example, you might fill out a digital form before a primary care visit.

Billing Clarification

When you provide the SDOH risk assessment as an additional element of the AWV, report HCPCS code G0136 for the SDOH risk assessment with Modifier –33, with the same DOS on the same claim as G0438 or G0439.

What are SDOH factors? ›

Social determinants of health (SDOH) are the nonmedical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age.

The new disclaimer looks like this: "We do not offer every plan available in your area. Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area.

In 2024, after paying the initial deductible, a person on Medicare will pay 25 percent of drug costs. They will have a cap of about $3,300 and will no longer pay five percent of drug costs in the catastrophic phase. In 2025, after paying the initial deductible, a person on Medicare will pay 25 percent of drug costs.

The 2024 Final Rule also introduces stricter standards for Medicare marketing and communications. These changes ensure that individuals with limited English proficiency (LEP) and disabilities can access important information in non-English languages and accessible formats.

The American Heart Association's 2024 Goal

Every person deserves the opportunity for a full, healthy life. As champions for health equity, by 2024, the American Heart Association will advance cardiovascular health for all, including identifying and removing barriers to health care access and quality.

Healthy People 2030 sets data-driven national objectives in five key areas of SDOH: healthcare access and quality, education access and quality, social and community context, economic stability, and neighborhood and built environment.