The healthcare industry is facing a significant debate over the reimbursement of clinical artificial intelligence (AI). The FDA has authorized 1,357 AI-enabled medical devices; however, insurance coverage remains limited. While experts like Ateev Mehrotra advocate for shifting the focus from individual technology payments to enhancing clinician productivity through AI, industry stakeholders worry that lack of reimbursement could hinder adoption. By 2026, the discussion will intensify as more AI devices are introduced. Currently, only three AI tools have permanent CPT codes from the AMA, crucial for Medicare reimbursement. Meanwhile, self-pay models are emerging, particularly in breast imaging, where patients often cover AI add-ons out of pocket due to absent insurance support. Health systems are investing in AI based on perceived value, validating their use through opportunistic screening that improves patient outcomes and drives revenue. Tracking these outcomes will be essential as financial implications for different clinical fields evolve.
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