National Government Services (NGS), a Medicare Administrative Contractor (MAC), has proposed denying Medicare coverage for AI-powered brain MRI exams.
This would be done through a Local Coverage Determination (LCD) that would deny coverage for automated detection and quantification of brain MRI technologies, which include CPT codes 0865T and 0866T.
The American College of Radiology (ACR) said the draft policy would affect clinical practices in the following states: Illinois, Minnesota, Wisconsin, Connecticut, New York, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont.
The proposed LCD and accompanying billing article are now open for public comment through March 8. The ACR said it encourages members, particularly neuroradiologists who use these AI tools, to review the proposals and consider submitting comments.
NGS will host a public open meeting on February 26 from noon to 2 p.m. ET to discuss the draft LCD and hear presentations from clinicians, stakeholders, and the public.
More information can be found on the ACR's site.
