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Medicare just created payment codes for AI. Everything changes now.
We’ve been waiting for this moment since ChatGPT launched.
CMS announced new CPT codes for AI-augmented care, and it’s bigger than most realize. Starting this year, providers can bill for:
• Diabetic retinopathy AI screening
• Coronary plaque AI assessment
• AI-assisted ECG analysis
• AI-enhanced echocardiograms
• AI-guided ultrasounds
But here’s what’s revolutionary:
These aren’t just add-on codes. They’re establishing AI as legitimate clinical infrastructure, not experimental tech.
💡 The real impact?
Smaller practices can finally justify AI investments. When you can bill for AI-enhanced diagnostics, the ROI calculation completely changes. That $50K AI platform suddenly makes financial sense.
CMS is also testing codes for inpatient deterioration prediction and triage optimization. Imagine getting reimbursed for AI that prevents readmissions or catches sepsis early.
The timing is perfect. NVIDIA just announced their new Vera Rubin chip will cut AI inference costs by 10x this year. Combine cheaper hardware with billable AI services, and we’re looking at widespread adoption by year end.
But here’s my concern:
Will these codes create a two-tier system? Practices with AI capabilities billing higher rates while safety net providers fall further behind?
FQHCs serving 30 million patients need these tools most, yet they’re least likely to afford the upfront costs, even with reimbursement promises.
The solution? CMS should create enhanced payment rates for AI adoption in underserved areas, similar to meaningful use incentives. Otherwise, health equity gaps will widen, not narrow.
This isn’t just about technology adoption anymore. It’s about who gets access to AI-enhanced care and who doesn’t.
The payment codes are here. The technology works. Now we need to ensure everyone benefits, not just those who can afford the entry fee.
♻️ Repost if AI in healthcare needs equitable payment models
👉 Follow me, Jonathan Govette, for daily, real-time updates on healthcare technology and business news. LinkedIn Profile: https://www.linkedin.com/in/jonathangovette/
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Author:
Jonathan Govette is a seasoned healthcare and technology executive with more than two decades of experience building, scaling, and advising digital health companies. He is the Co-Founder and CEO of Oatmeal Health, an AI-driven Lung Cancer Screening and Diagnostics company focused on expanding access to early detection for underrepresented populations, particularly patients served by Federally Qualified Health Centers and value-based health plans.
With a background in engineering, product development, and strategic partnerships, Jonathan has founded and led multiple health technology ventures across clinical care delivery, regulated medical software, and AI-enabled diagnostics. His work sits at the intersection of medicine, technology, and health equity, with a consistent focus on translating complex clinical problems into scalable, real-world solutions.
Jonathan has spent much of his professional life dedicated to improving outcomes for marginalized and underserved communities. He has designed and implemented frameworks that align clinical quality, reimbursement, and technology to sustainably advance health equity at scale. This mission is deeply personal and informs his leadership philosophy and long-term vision for healthcare transformation.
In addition to his operating experience, Jonathan is an author and long-time writer in the healthcare domain, with over 20 years of published work covering digital health, medical innovation, and healthcare systems. He is a frequent mentor to early-stage founders and regularly advises startups on product strategy, partnerships, and go-to-market execution in regulated healthcare environments.
Before entering industry full-time, Jonathan nearly pursued a career in medicine with an early path toward cardiothoracic surgery, an experience that continues to shape his clinical perspective and respect for frontline care delivery.
CEO | Oatmeal Health | AI Lung Cancer Startup | Engineer | Writer | Almost Became a Doctor (Cardiac Thoracic Surgeon) | 3x Health Tech Founder | Startup Mentor | Follow to share what I’ve learned along the way.
