A Medicare contractor has proposed denying coverage for AI tools used in brain MRI analysis, citing insufficient evidence and data limitations.
Key Details
- 1National Government Services has issued a proposed decision to deny coverage for AI-powered brain MRI assessment tools.
- 2The proposal affects automated detection and quantification technologies using CPT codes 0865T and 0866T.
- 3If finalized, denial would impact radiology providers across several Midwest and Northeastern U.S. states.
- 4The decision cites a lack of diverse datasets and insufficient evidence of clinical utility, especially for the Medicare population.
- 5Public comments on the proposal are open through March 8.
Why It Matters
This move could restrict access to AI-based tools that support radiologists in brain MRI interpretation, particularly for neurodegenerative diseases. Lack of Medicare coverage may slow adoption and further research of imaging AI in clinical practice.
Source
Radiology Business
Related News
•HealthExec
AI Reimbursement, Biomedical Research, and Exec Survey Highlight Healthcare Trends
Healthcare AI adoption is rising, but ROI measurement and clinical impact remain key challenges.
•HealthExec
Senate Vote Fails to Block AI Medicare Prior Authorization Pilot
A Senate vote failed to halt the WISeR AI-based prior authorization pilot for traditional Medicare claims.
•AuntMinnie
Radiologists Struggle to Spot AI-Generated Radiology Images
Radiologists correctly identify AI-generated images 75% of the time, with CT and MRI images being particularly challenging to spot.