Radiology AI triage solution earns separate, additional Medicare hospital payment
Vendor Annalise.ai has scored what it says is the only separate, additional Medicare hospital payment for a radiology AI triage solution.
The Centers for Medicare & Medicaid Services revealed the news under the 2025 Inpatient Prospective Payment System rule released on Aug. 1. Annalise.ai has secured a Medicare New Technology Add-on Payment for its solution, which flags noncontrast CT scans suspected of obstructive hydrocephalus.
This life-threatening condition involves the build-up of cerebrospinal fluid in the brain and can be fatal if not treated urgently, the company said. Annalise.ai also achieved breakthrough device status for the product from the U.S. Food and Drug Administration last year.
“Annalise Critical Care AI has garnered significant interest due to its clinical capabilities. With the introduction of additional Medicare payments, we anticipate more adoption of our technology by hospital systems, improving patient outcomes,” Aengus Tran, MD, co-founder and CEO of Annalise.ai, said in an Aug. 2 announcement.
Prompt diagnosis of obstructive hydrocephalus can be challenging, Tran and colleagues noted, as its clinical presentation overlaps with other neurological issues. Annalise.ai’s solution pinpoints findings suggestive of this concern “within minutes,” flagging them on the radiologist’s work list. In scientific studies, the solution has demonstrated “excellent performance,” including sensitivity of 97.5% and specificity of 95.3%.
The IPPS rule limits reimbursement for discharged Medicare inpatients to the lesser of 65% of the average technology cost or 65% of costs above Medicare Severity Diagnosis Related Groups. This would result in an add-on payment for a case using the triage software at about $241.39 (65% of the average cost of the technology), attorney and radiology policy expert Tom Greeson wrote Aug. 5.
In the IPPS rule, Annalise.ai estimated that the average cost per case was roughly $371.37. Hospitals acquire the Sydney, Australia-based company’s triage system via a subscription-based model with an annual cost of $180,000 per institution. Annalise.ai calculated the per-patient cost by dividing this figure by the estimated number of noncontrast CT scans that would benefit from using the algorithm.
You can read further details about the Medicare decision in the rule here (starting on page 550).
Editor's Note: An earlier version of this story incorrectly stated that Annalise.ai is the first to achieve separate Medicare hospital payment for a radiology AI triage solution. However, Viz.ai previously achieved this feat. Radiology Business regrets this error.
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.