Heard at MedTech: Notable Policy Developments Discussed in San Diego

AdvaMed’s annual The MedTech Conference is always a rich source of new details and forward-looking insights on medtech policy issues. Here are the most interesting things Market Pathways heard at this year’s conference in San Diego.

AI CPT Confab Coming in December

The American Medical Association is planning a special meeting in Chicago for December to hear from stakeholders, including medtech innovators, investors, and payors, on a newly proposed framework for assigning CPT codes to advanced AI algorithm-enabled services.

The AMA’s CPT Editorial Panel has been able to award CPT codes to some specific AI offerings, but group leaders say they have been running into barriers as a growing number of AI systems are crafted to work more autonomously in the healthcare arena, removing the component of “clinician work” that underlies standard code assignments. The December meeting, which will also include virtual participation, was announced during an October 6 panel discussion at The MedTech Conference. It is intended to give stakeholders a chance to weigh in on the panel’s ongoing effort to create a new, distinct section of the CPT code set for AI systems, referred to as Clinically Meaningful Algorithmic Analysis (CMAA), and the project’s implications for reimbursement in the space. 

“There's some concern from investors that if we create this new section and it's not fully integrated with coverage and payment, that the codes that go into that section may be sort of in a limbo,” explained Richard Frank, MD, a voting member of the CPT panel and chair of the committee developing the CMAA framework, during the panel discussion. “It's important that CPT not do this in isolation, but that we communicate with others, such as the payors, to ensure that it actually is not a blind alley.”