How AI can flag critical imaging results for priority review and treatments

When the U.S. Centers for Medicare and Medicaid Services (CMS) approved a new technology add-on payment (NTAP) for large-vessel occlusion (LVO) stroke triage and notification software in 2020, the decision made a good business case for AI in early detection of stroke.

It meant that the AI technology was seen as a substantial clinical improvement over existing services. It set a precedent, Gregory Nicola, MD, chair of the American College of Radiology (ACR) Commission on Economics wrote in an ACR practice management bulletin at the time. Providers that used Viz LVO, for example, to triage suspected stroke patients could bill Medicare for up to $1,040 per use. The potential drawback was expiration of the add-on payments.

Notably, CMS estimated that overall, additional payments for inpatient cases involving new medical technologies will decrease by $364 million in fiscal year 2024 as a result of NTAP expirations. In addition, the agency changed its NTAP policies starting in fiscal year 2024 to increase transparency and improve efficiency of the NTAP program and application process.