Current Reimbursement Landscape of Artificial Intelligence.

Journal: Journal of the American College of Radiology : JACR
Published Date: Oct 1, 2023

Abstract

One of the biggest hurdles to widespread adoption of new procedures and technology such as artificial intelligence (AI) algorithms is payment and coverage policy. Noninvasive assessment of coronary fractional flow reserve is one AI imaging algorithm that will successfully achieve reimbursement through multiple pathways of CMS payment mechanisms in 2024. CMS is the largest provider of health care in the United States. Understanding how this AI algorithm is paid through the different fee schedules will help to understand the challenges CMS has in paying for new services and innovation in the United States.

Authors

  • George Wu
    Department of Radiology, Baylor College of Medicine, Houston, Texas.
  • Colin S Segovis
    Medical Director for the Revenue Cycle Operations, Director of MRI Quality and Safety, Codirector of Radiology Elective Clerkship for the Department of Radiology and Imaging Sciences, Department of Radiology, Emory University School of Medicine, Atlanta, Georgia; American Society of Neuroradiology CPT (Current Procedure Terminology) Advisor, Chair of the ASNR Economics Committee and Treasurer of the Georgia Radiological Society.
  • Lauren P Nicola
    Chief Executive Officer, Triad Radiology Associates, Winston Salem, North Carolina; Inpatient Medical Director of Novant Forsyth Medical Center, ACR Relative Value Scale Update Committee Advisor, Chair of the ACR Reimbursement Committee, and member of the ACR Board of Chancellors as the Chair of the Ultrasound Commission.
  • Melissa M Chen
    From the Department of Imaging Physics (Z.Z., J.W.S., J.B.S., J.M.), Medical Physics Graduate Program, UTHealth Graduate School of Biomedical Sciences (J.W.S.), Department of Diagnostic Radiology (J.M.J., M.K.G., M.M.C.), Department of Radiation Physics (T.M.B.), Department of Radiation Oncology (Y.W., J.L.), and Department of Cancer Systems Imaging (M.D.P.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030.

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