LAUSR

The Centers for Medicare and Medicaid Services (CMS) recently granted a New Technology Add-on Payment (NTAP) for Viz ContaCT (Viz LVO) by Viz.ai, Inc, an applied artificial intelligence healthcare company.1 This is the first time CMS has reimbursed an artificial intelligence (AI)-based software using this designation. It applies to Viz.ai’s acute ischemic stroke product, Viz LVO, officially known as Viz ContaCT, under which the ICD-10 Procedure Coding System (ICD-10-PCS) procedure code 4A03×5D was established. Viz ContaCT is an AI-based system that creates a parallel alert system whenever it detects a large vessel occlusion (LVO) on a computed tomography angiogram. The images are viewable on a mobile application which combines HIPAA (Health Insurance Portability and Accountability Act)-compliant group messaging functionality with a mobile PACS Viewer. Users can view the images, make triage decisions, and communicate with other members of the care team through chat functionality. Beyond the specific designation, this decision may have far-reaching implications for stroke care and for reimbursement of AI-enabled applications. ### What is NTAP? At a national level, reimbursement is how health care incentivizes helping patients. Medicare pays for a patient’s hospital stay according to the Inpatient Prospective Payment System (IPPS) under a single bundled payment, which includes all costs. These payments are captured under the Medicare Severity Diagnosis-Related Group (MS-DRG) system. While the MS-DRG rates are updated annually, the payments are based on Medicare claims data accrued over a 2 to 3 year period. The result is that payments lag behind true costs, particularly for care using new and expensive technologies.2 Introduced in 2001, the CMS NTAP program was created by Congress to help close this gap and support timely access to innovative therapies for the Medicare population. For technologies accepted under this program, CMS provides an additional payment to hospitals above the standard MS-DRG payment amount. There is …