Medicare approves new technology add-on payment for inpatient radiology AI solution
Marty Stempniak|August 14, 2026|Radiology Business|Artificial Intelligence
Medicare has approved a new technology add-on payment for a key radiology artificial intelligence solution under the recently finalized inpatient payment rule.
The federal insurance program for seniors will pay a maximum of $137.53 per case in 2027 for BriefCase-Triage. Manufactured by radiology vendor Aidoc, the CARE (Clinical AI Reasoning Engine) Multi-Triage CT Body tool uses AI to analyze computed tomography images, flagging potentially urgent findings such as appendicitis or a bowel obstruction.
Medicare approved a total of 22 new products, which also received the Food and Drug Administration’s breakthrough device designation, through the “alternative” payment pathway. Another 8 scored reimbursement through Medicare’s traditional payment pathway. Altogether, CMS will spend an additional $779 million for inpatient cases involving emerging medical innovations in fiscal 2027, primarily driven by new technology add-on payments (NTAP).
“Health systems are under increasing pressure to help patients receive accurate diagnoses sooner while managing growing imaging demand and persistent workforce shortages,” Elad Walach, CEO and co-founder of New York-based Aidoc, said in a statement Aug. 13. “By creating a reimbursement pathway for eligible use of diagnostic AI, the NTAP program is helping patients get earlier access to this transformative new technology.”
The CARE CT Body Triage payment figure represents about 65% of the average cost of the technology, the American College of Radiology noted in a summary of the final rule shared Thursday. Cases involving use of the AI product that are eligible for add-on payments will be identified by ICD-10-PCS procedure code XEZ5XKC (computer-aided triage and notification for imaging abnormalities in computed tomography of chest, abdomen and pelvis, new technology group 12), ACR added.
Aidoc said the CT Body Triage device scans for a broad set of acute findings. Beginning Oct. 1, hospitals using it will be eligible for add-on payments spanning the next three years. This is aimed at helping offset the cost of adopting new technologies, granting seniors greater access to emerging diagnostic and treatment tools. The FDA previously granted CT Body Triage its breakthrough designation in September 2025 and 501k clearance in January
Devices approved through the “traditional” payment pathway require proof of substantial clinical improvement, while the “alternative” waives this requirement for eligible FDA-designated breakthrough technologies. In the final rule, CMS said it is repealing the alternative pathway for new payments beginning with applications received for fiscal 2028. Going forward from then, it will require all applicants to meet the more stringent traditional rules.
In the initial proposed rule, CMS expressed concerns with the limited evaluation process for alternative applications, ACR reported. After further consideration, the agency believes it was best to refine its approach to granting payments, ensuring that reimbursed technologies are not substantially similar to existing products, and are able to improve diagnosis and treatment for seniors. Medicare is doing the same for other radiology AI devices that earn payment approval on the hospital outpatient side.
“CMS believes this requirement will better align spending and value and ultimately support providers in delivering the best, data driven care possible,” ACR said in its six-page summary of the final rule. “By requiring all technologies to demonstrate that they offer a substantial clinical improvement as part of our evaluation process, we believe we will be better able to make evidence-based decisions on which technologies should receive these additional payments.”
You can read much more in ACR’s write-up, the CMS fact sheet, and in the final rule. Altogether, the agency is finalizing a 2.3% payment update for treating inpatients, increasing hospital payments by $2.1 billion for fiscal 2027
Marty Stempniak
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association’s member magazine, Modern Healthcare and McKnight’s. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.
