ARTICLE SUMMARY:
The group plans to convene experts and stakeholders in Chicago in December to discuss a newly proposed CPT coding framework for AI software services that don’t involve a clinician work component. A major focus will be on how the envisioned system will translate into consistent reimbursement for these rapidly evolving technologies.
The American Medical Association says it wants to fill the gaps in how AI-enabled software can be identified, billed, and paid for in the US healthcare system. The physician organization plans to convene a public meeting December 8 to bring together experts, including medtech innovators, to discuss a newly proposed framework for coding these rapidly evolving digital technologies.
The AMA’s CPT Editorial Panel is a crucial market access gatekeeper for medtech, establishing the codes that formally describe each medical service and procedure, which allows the care to be tracked and billed to Medicare and all other payors. Product developers have long complained that the CPT coding process is overly complex and opaque, and doesn’t readily lead to a clear path to reimbursement for emerging technologies. The Editorial Panel has taken steps over the past decade to modernize its process to better accommodate new innovations, with a particular focus on finding ways to incorporate digital health into the system.
