--- title: Reimbursement for Artificial Intelligence in Radiology | HAP description: The radiology community is abuzz with talk of artificial intelligence systems that can assist physicians with image interpretation and perform other tasks. image: https://info.hapusa.com/hubfs/Reimbursement%20for%20Artificial%20Intelligence%20in%20Radiology%20is%20More%20Than%20Just%20Billable%20Codes.jpg --- ![Reimbursement for Artificial Intelligence in Radiology is More Than Just Billable Codes](https://info.hapusa.com/hubfs/Reimbursement%20for%20Artificial%20Intelligence%20in%20Radiology%20is%20More%20Than%20Just%20Billable%20Codes.jpg) # Reimbursement for Artificial Intelligence in Radiology is More Than Just Billable Codes - [Home](https://info.hapusa.com/) - [HAP Radiology Billing and Coding Blog](https://info.hapusa.com/blog-0) - Reimbursement for Artificial Intelligence in Radiology is More Than Just Billable Codes [ Sandy Coffta ](https://info.hapusa.com/blog-0/author/sandy-coffta) 04/05/2021 ## Reimbursement for Artificial Intelligence in Radiology is More Than Just Billable Codes ![Reimbursement for Artificial Intelligence in Radiology is More Than Just Billable Codes](https://info.hapusa.com/hubfs/Reimbursement%20for%20Artificial%20Intelligence%20in%20Radiology%20is%20More%20Than%20Just%20Billable%20Codes.jpg "Reimbursement for Artificial Intelligence in Radiology is More Than Just Billable Codes") ![Reimbursement for Artificial Intelligence in Radiology is More Than Just Billable Codes](https://info.hapusa.com/hs-fs/hubfs/Reimbursement%20for%20Artificial%20Intelligence%20in%20Radiology%20is%20More%20Than%20Just%20Billable%20Codes.jpg?width=300&name=Reimbursement%20for%20Artificial%20Intelligence%20in%20Radiology%20is%20More%20Than%20Just%20Billable%20Codes.jpg)The radiology community is abuzz with talk of artificial intelligence (AI) systems that can assist physicians with image interpretation and perform other tasks. Like any new technology, it will take time before AI gains widespread acceptance due to the cost of implementation. This is analogous to the early-day PACS, where the benefits of efficiency had to be proven in order to justify the expenditure for such a costly system. Today almost all imaging is interpreted on computer systems … when was the last time anyone looked at a piece of film?   Artificial Intelligence appears in many different systems that are designed to do many different things. The imaging news source [*AuntMinnie.com*](https://www.auntminnie.com/Artificial-Intelligence) has a section dedicated to AI, and recently listed articles describing systems that - Detect physical child abuse - Identify orthopedic implants make and model on radiographs - Speed up quantitative volumetric MRI - Predict complications from CT-guided biopsy - Perform radiation therapy contouring, and - Analyze chest CT to shorten turnaround time. Our own [Deep Dive Analytics](https://www.hapusa.com/services/clinical-analytics/) solution has been used to identify patients in need of follow-up to remind them to return for prescribed imaging and implanted device removal, among other uses. [Our blog contains a number of articles describing the use of the system.](https://info.hapusa.com/blog-0/topic/clinical-analytics) [![Get Our Top 10 Radiology RCM Tips](https://no-cache.hubspot.com/cta/default/16707/301a07a9-015b-4e16-b124-8dca2c26db82.png)](https://cta-redirect.hubspot.com/cta/redirect/16707/301a07a9-015b-4e16-b124-8dca2c26db82) Medicare will now pay for the use of artificial intelligence in only two limited cases – diagnosis of diabetic retinopathy under the Medicare Physician Fee Schedule (MPFS) and diagnosis and treatment of large-vessel occlusion strokes under the Inpatient Prospective Payment System (IPPS). The latter is a payment to hospitals that does not provide any professional component reimbursement to radiologists. *The Imaging Wire* pointed us to the article [Who Will Pay for AI?](https://doi.org/10.1148/ryai.2021210030) by Drs. Melissa M. Chen, Lauren Parks Golding, and Gregory N. Nicola, that was published March 3, 2021 by the Radiology Society of North America ([RSNA](https://www.rsna.org/)). The authors conclude that “Payment for AI in the current fee-for-service environment may be challenging, and sustained adoption of AI may not occur within the framework of the IPPS and Physician Fee Schedule.” They suggest that AI might have a bigger role in value-based systems such as the Alternative Payment Models (APM) that are part of Medicare’s [Quality Payment Program](https://qpp.cms.gov/).   Direct reimbursement for the use of AI is only one piece of the puzzle. In order to gain widespread usage, AI systems will have to provide a Return On Investment (ROI) in terms of cost savings or increased volume rather than direct reimbursement. For example, the use of Deep Dive Analytics not only provides improved patient care, but when patients return for regular follow-up imaging the practice benefits from the scan volume. When an implanted device such as an IVC filter is removed in a timely manner, it provides appropriate procedural revenue and also helps to establish the radiologist’s value in the medical community.   One upcoming use of AI is in clinical decision support (CDS). The use of CDS has been mandated by Medicare for certain imaging procedures beginning in 2022, with financial penalties applied to radiologists who perform exams without the ordering physician having consulted a CDS. The use of AI in a medical community with an integrated information system can make this required process easier for ordering physicians, thereby reducing the risk of denied payment to radiologists.   The [American College of Radiology](https://www.acr.org/), along with several other radiology interest groups, have [proposed](https://www.acr.org/Advocacy-and-Economics/Advocacy-News/Advocacy-News-Issues/In-the-Feb-13-2021-Issue/ACR-Presents-Code-Proposals-at-CPT-Editorial-Panel-Meeting) new radiology-specific CPT® codes that include quantitative ultrasound tissue characterization (non-elastographic) and artificial intelligence analysis for detection of vertebral fractures. If they are approved, they would be temporary Category III codes that are usually assigned to emerging or experimental technologies and not generally reimbursed by most payers until permanent codes and RVU values are assigned. The proposed codes could be released in July for potential use in 2022, although final adoption of permanent codes could take several years. [![Contact Us](https://no-cache.hubspot.com/cta/default/16707/1088478d-a9f7-4565-8dac-15dab49f67ca.png)](https://cta-redirect.hubspot.com/cta/redirect/16707/1088478d-a9f7-4565-8dac-15dab49f67ca) We no doubt will hear much more about the integration of AI into private practice. The [*Journal of the American College of Radiology*](https://www.jacr.org/call-for-papers) has called for case studies on the topic, and we look forward to learning about the ways practices have implemented cost-effective systems. [Subscribe to this blog ](https://info.hapusa.com/subscribe-to-hap-medical-billing-and-coding-blog)to get the latest on the state-of-the-art in radiology AI.   *[Sandy Coffta](https://info.hapusa.com/download-a-copy-of-sandy-coffta-professional-summary) is the Vice President of Client Services at [Healthcare Administrative Partners](https://www.hapusa.com/). * **Related Articles**   [Federal Programs to Assist Radiology Practices During the Pandemic](https://info.hapusa.com/blog-0/federal-programs-to-assist-radiology-practices-during-the-pandemic)   [Update on The Quality Payment Program](https://info.hapusa.com/blog-0/update-on-the-quality-payment-program)   [Evaluation and Management Coding and Billing for Interventional Radiology](https://info.hapusa.com/blog-0/evaluation-and-management-coding-and-billing-for-interventional-radiology)   [![Inside advice from radiology RCM experts](https://no-cache.hubspot.com/cta/default/16707/f1acf195-e6b4-46f0-bdb2-e0bf10079237.png)](https://cta-redirect.hubspot.com/cta/redirect/16707/f1acf195-e6b4-46f0-bdb2-e0bf10079237) [Follow HAP on LinkedIn](https://www.linkedin.com/company/healthcare-administrative-partners) [Follow HAP on Twitter](https://twitter.com/hapusarcm) [Like HAP on Facebook ](https://www.facebook.com/hapusarcm/) --- #### Share: - [Follow us on Facebook ](http://www.facebook.com/share.php?u=https://info.hapusa.com/blog-0/reimbursement-for-artificial-intelligence-in-radiology-is-more-than-just-billable-codes) - [Follow us on Twitter ](https://twitter.com/intent/tweet?url=https://info.hapusa.com/blog-0/reimbursement-for-artificial-intelligence-in-radiology-is-more-than-just-billable-codes&text=Reimbursement%20for%20Artificial%20Intelligence%20in%20Radiology%20is%20More%20Than%20Just%20Billable%20Codes) - [Follow us on Linkedin ](http://www.linkedin.com/shareArticle?mini=true&url=https://info.hapusa.com/blog-0/reimbursement-for-artificial-intelligence-in-radiology-is-more-than-just-billable-codes) - [Follow us on Mail ](mailto:?subject=Reimbursement%20for%20Artificial%20Intelligence%20in%20Radiology%20is%20More%20Than%20Just%20Billable%20Codes%20&%20body=https://info.hapusa.com/blog-0/reimbursement-for-artificial-intelligence-in-radiology-is-more-than-just-billable-codes) - Follow us on Copy Copied to clipboard --- [ #### Federal Programs to Assist Radiology Practices During the Pandemic ##### Previous Post ](https://info.hapusa.com/blog-0/federal-programs-to-assist-radiology-practices-during-the-pandemic) [#### Radiology Groups Can Prepare Now to Implement the No Surprises Act ##### Next Post ](https://info.hapusa.com/blog-0/radiology-groups-can-prepare-now-to-implement-the-no-surprises-act) ### Leave a Reply --- ## Related Posts [ regulatory](https://info.hapusa.com/blog-0/topic/regulatory), [ radiology](https://info.hapusa.com/blog-0/topic/radiology) [ Sandy Coffta ](https://info.hapusa.com/blog-0/author/sandy-coffta) 28 May, 2026 #### [Legislation & Regulations That Could Affect Radiology Practices](https://info.hapusa.com/blog-0/legislation-regulations-that-could-affect-radiology-practices) H.R. 8163, the Provider Reimbursement Stability Act of 2026 Medicare payment reform is one of the... [Read More](https://info.hapusa.com/blog-0/legislation-regulations-that-could-affect-radiology-practices) [ radiology](https://info.hapusa.com/blog-0/topic/radiology), [ interventional radiology billing](https://info.hapusa.com/blog-0/topic/interventional-radiology-billing), [ office based labs](https://info.hapusa.com/blog-0/topic/office-based-labs) [ Sandy Coffta ](https://info.hapusa.com/blog-0/author/sandy-coffta) 06 May, 2026 #### [Expanding Opportunities for Interventional Radiology Practice](https://info.hapusa.com/blog-0/expanding-opportunities-for-ir-practice) Most radiology groups practice within a hospital facility setting, but many also work in... [Read More](https://info.hapusa.com/blog-0/expanding-opportunities-for-ir-practice) [ radiology](https://info.hapusa.com/blog-0/topic/radiology) [ HAP USA ](https://info.hapusa.com/blog-0/author/hap-usa) 31 March, 2026 #### [What's HAPpening in Radiology - Q1 2026](https://info.hapusa.com/blog-0/whats-happening-in-radiology-q1-2026) Healthcare Administrative Partners (HAP) continually monitors issues that affect your radiology... [Read More](https://info.hapusa.com/blog-0/whats-happening-in-radiology-q1-2026)