Signify Premium Insight: The Race for Reimbursement

Published: August 3, 2021

Last month, the American Medical Association (AMA) approved the first current procedural terminology (CPT) codes for AI specific to radiology, including Category III codes for incidental vertebral fracture detection, and quantitative ultrasound tissue characterisation. The code for the incidental detection of vertical compression fractures (VCF) could, by codifying the automatic analysis of chest CTs, pave the way for many more AI-specific CPT codes. This code could, further down the line, also lead to the use of AI in population-based screening programmes (e.g. for osteoporosis). The codes for ultrasound tissue characterisation could, meanwhile, move the market forward for key ultrasound exams, and several vendors offering AI decision support solutions. None of these AI CPT codes, which are set to come into force in January 2022, are associated with a relative value unit (RVU), and so are not given a reimbursement value.


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