Characterizing the clinical adoption of medical AI devices through U.S. insurance claims
Open accessAbstract
There are now over 500 medical artificial intelligence (AI) devices that are approved by the U.S. Food and Drug Administration. However, little is known about where and how often these devices are actually used after regulatory approval. In this article, we systematically quantify the adoption and usage of medical AI devices in the United States by tracking Current Procedural Terminology (CPT) codes explicitly created for medical AI. CPT codes are widely used for documenting billing and payment for medical procedures, providing a measure of device utilization across different clinical settings. We examined a comprehensive nationwide claims database of 11 billion CPT claims between January 1, 2018, and June 1, 2023 to analyze the prevalence of medical AI devices based on submitted claims. Our results indicate that medical AI device adoption is still nascent, with most usage driven by a handful of leading devices. For example, only AI devices used for assessing coronary artery disease and for diagnosing diabetic retinopathy have accumulated more than 10,000 CPT claims. Furthermore, we found that zip codes that had a higher income level, were metropolitan, and had academic medical centers were much more likely to have medical AI usage. Our study sheds light on the current landscape of medical AI device adoption and usage in the United States, underscoring the need to further investigate barriers and incentives to promote equitable access and broader integration of AI technologies in health care.
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Utilization of autonomous AI for DR testing has been scaling rapidly.
“and as a result utilization has been scaling rapidly26,27.”
From Autonomous AI-assisted diabetic retinopathy screening at primary care is associated with increased presentation to eye care by at risk patients (2026) · cites this paper as [26]
Lack of reimbursement makes it challenging to assess the true extent of clinical integration, because traditional methods such as insurance claims data cannot be used except for a small number of applications.
“This lack of reimbursement also makes it challenging to assess the true extent of clinical integration, as traditional methods for measuring medical device use such as insurance claims data cannot be used except for a small number of applications (211).”
From Artificial Intelligence in Oncology: Current Landscape, Challenges, and Future Directions (2024) · cites this paper as [211]
Cites
Do no harm: a roadmap for responsible machine learning for health care
Wiens, J., Saria, S., Sendak, M., Ghassemi, M., Liu, V. X., Doshi-Velez, F., Jung, K., Heller, K., Kale, D., Saeed, M., et al. (2019) · Nature Medicine · doi:10.1038/s41591-019-0548-6 · Cited by 1,266 · see citing works
Benjamens, S., Dhunnoo, P., & Meskó, B. (2020) · npj Digital Medicine · doi:10.1038/s41746-020-00324-0 · Cited by 1,215 · see citing works
The imperative for regulatory oversight of large language models (or generative AI) in healthcare
Meskó, B., & Topol, E. J. (2023) · npj Digital Medicine · doi:10.1038/s41746-023-00873-0 · Cited by 1,047 · see citing works
Wong, A., Otles, E., Donnelly, J. P., Krumm, A., McCullough, J., DeTroyer-Cooley, O., Pestrue, J., Phillips, M., Konye, J., Penoza, C., et al. (2021) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2021.2626 · Cited by 995 · see citing works
Diagnostic Accuracy of Digital Screening Mammography With and Without Computer-Aided Detection
Lehman, C. D., Wellman, R. D., Buist, D. S. M., Kerlikowske, K., Tosteson, A. N. A., & Miglioretti, D. L. (2015) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2015.5231 · Cited by 678 · see citing works
Beede, E., Baylor, E., Hersch, F., Iurchenko, A., Wilcox, L., Ruamviboonsuk, P., & Vardoulakis, L. M. (2020) · Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems · doi:10.1145/3313831.3376718 · Cited by 614 · see citing works
Wu, E., Wu, K., Daneshjou, R., Ouyang, D., Ho, D. E., & Zou, J. (2021) · Nature Medicine · doi:10.1038/s41591-021-01312-x · Cited by 494 · see citing works
Self-citationImpact of a deep learning assistant on the histopathologic classification of liver cancer
Kiani, A., Uyumazturk, B., Rajpurkar, P., Wang, A., Gao, R., Jones, E., Yu, Y., Langlotz, C. P., Ball, R. L., Montine, T. J., et al. (2020) · npj Digital Medicine · doi:10.1038/s41746-020-0232-8 · Cited by 325 · see citing works
Barrett, C. E., Koyama, A. K., Alvarez, P., Chow, W., Lundeen, E. A., Perrine, C. G., Pavkov, M. E., Rolka, D. B., Wiltz, J. L., Bull–Otterson, L., et al. (2022) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm7102e2 · Cited by 293 · see citing works
Singh, R. P., Hom, G. L., Abramoff, M. D., Campbell, J. P., Chiang, M. F., & on behalf of the AAO Task Force on Artificial Intelligence (2020) · Translational Vision Science & Technology · doi:10.1167/tvst.9.2.45 · Cited by 259 · see citing works
Characteristics of publicly available skin cancer image datasets: a systematic review
Wen, D., Khan, S. M., Ji Xu, A., Ibrahim, H., Smith, L., Caballero, J., Zepeda, L., de Blas Perez, C., Denniston, A. K., Liu, X., et al. (2022) · The Lancet Digital Health · doi:10.1016/s2589-7500(21)00252-1 · Cited by 243 · see citing works
Geographic Distribution of US Cohorts Used to Train Deep Learning Algorithms
Kaushal, A., Altman, R., & Langlotz, C. (2020) · JAMA · doi:10.1001/jama.2020.12067 · Cited by 239 · see citing works
Evaluation of Artificial Intelligence–Based Grading of Diabetic Retinopathy in Primary Care
Kanagasingam, Y., Xiao, D., Vignarajan, J., Preetham, A., Tay-Kearney, M.-L., & Mehrotra, A. (2018) · JAMA Network Open · doi:10.1001/jamanetworkopen.2018.2665 · Cited by 185 · see citing works
Administration, U. S. F. &. D. (2018) · Case Medical Research · doi:10.31525/fda2-ucm604357.htm · Cited by 146 · see citing works
Paying for artificial intelligence in medicine
Parikh, R. B., & Helmchen, L. A. (2022) · npj Digital Medicine · doi:10.1038/s41746-022-00609-6 · Cited by 132 · see citing works
Gao, Y., Geras, K. J., Lewin, A. A., & Moy, L. P. (2019) · American Journal of Roentgenology · doi:10.2214/ajr.18.20392 · Cited by 125 · see citing works
Artificial Intelligence in Medicine: Chances and Challenges for Wide Clinical Adoption
Varghese, J. (2020) · Visceral Medicine · doi:10.1159/000511930 · Cited by 119 · see citing works
A reimbursement framework for artificial intelligence in healthcare
Abràmoff, M. D., Roehrenbeck, C., Trujillo, S., Goldstein, J., Graves, A. S., Repka, M. X., & Silva III, E. “. (2022) · npj Digital Medicine · doi:10.1038/s41746-022-00621-w · Cited by 117 · see citing works
Current procedural terminology; a primer
Hirsch, J. A., Leslie‐Mazwi, T. M., Nicola, G. N., Barr, R. M., Bello, J. A., Donovan, W. D., Tu, R. K., Alson, M. D., & Manchikanti, L. (2014) · Journal of NeuroInterventional Surgery · doi:10.1136/neurintsurg-2014-011156 · Cited by 102 · see citing works
Assessing the Economic Value of Clinical Artificial Intelligence: Challenges and Opportunities
Hendrix, N., Veenstra, D. L., Cheng, M. M., Anderson, N. C., & Verguet, S. (2021) · Value in Health · doi:10.1016/j.jval.2021.08.015 · Cited by 85 · see citing works
Chen, M., Golding, L. P., & Nicola, G. N. (2021) · Radiology Artificial Intelligence · doi:10.1148/ryai.2021210030 · Cited by 82 · see citing works
Assessment and effect of a gap between new-onset epilepsy diagnosis and treatment in the US
Kalilani, L., Faught, E., Kim, H., Burudpakdee, C., Seetasith, A., Laranjo, S., Friesen, D., Haeffs, K., Kiri, V. A., & Thurman, D. J. (2019) · Neurology · doi:10.1212/wnl.0000000000007448 · Cited by 68 · see citing works
Lessons learned from translating AI from development to deployment in healthcare
Widner, K., Virmani, S., Krause, J., Nayar, J., Tiwari, R., Pedersen, E. R., Jeji, D., Hammel, N., Matias, Y., Corrado, G. S., et al. (2023) · Nature Medicine · doi:10.1038/s41591-023-02293-9 · Cited by 62 · see citing works
The Medicare Conversion Factor
Seidenwurm, D. J., & Burleson, J. (2013) · American Journal of Neuroradiology · doi:10.3174/ajnr.a3674 · Cited by 59 · see citing works
Feuerstadt, P., Stong, L., Dahdal, D. N., Sacks, N. C., Lang, K., & Nelson, W. W. (2020) · Journal of Medical Economics · doi:10.1080/13696998.2020.1724117 · Cited by 58 · see citing works
van Leeuwen, K. G., de Rooij, M., Schalekamp, S., van Ginneken, B., & Rutten, M. J. C. M. (2023) · European Radiology · doi:10.1007/s00330-023-09991-5 · Cited by 53 · see citing works
Royston, M., Kielhorn, A., Weycker, D. A., et al. (2021) · Neurology and Therapy · doi:10.1007/s40120-021-00253-4 · Cited by 46 · see citing works
Economic Evaluations of Artificial Intelligence in Ophthalmology
Ruamviboonsuk, P., Chantra, S., Seresirikachorn, K., Ruamviboonsuk, V., & Sangroongruangsri, S. (2021) · Asia-Pacific Journal of Ophthalmology · doi:10.1097/apo.0000000000000403 · Cited by 45 · see citing works
New Technology Add-On Payment (NTAP) for Viz LVO: a win for stroke care
Hassan, A. E. (2020) · Journal of NeuroInterventional Surgery · doi:10.1136/neurintsurg-2020-016897 · Cited by 44 · see citing works
IDx-DR for Diabetic Retinopathy Screening.
Savoy, M. L. (2020) · PubMed · Cited by 37 · see citing works
Murage, M. J., Anderson, A., Casso, D., et al. (2018) · Journal of Dermatological Treatment · doi:10.1080/09546634.2018.1479725 · Cited by 32 · see citing works
Real-World Assessment of Asthma Specialist Visits Among U.S. Patients with Severe Asthma
Most, J. F., Ambrose, C. S., Chung, Y., et al. (2021) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2021.05.003 · Cited by 27 · see citing works
Berger, J. S., Laliberté, F., Kharat, A. A., Lejeune, D., Moore, K. T., Jung, Y. Y., Lefèbvre, P., & Ashton, V. (2021) · Current Medical Research and Opinion · doi:10.1080/03007995.2021.1901223 · Cited by 26 · see citing works
CPT®: An Open System That Describes All That You Do
Thorwarth, W. T. (2008) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2007.10.004 · Cited by 24 · see citing works
US Insurer Spending on Ivermectin Prescriptions for COVID-19
Chua, K., Conti, R. M., & Becker, N. V. (2022) · JAMA · doi:10.1001/jama.2021.24352 · Cited by 24 · see citing works
Jolles, S. R. A., Smith, B. D., Vinh, D. C., Mallick, R., Espinoza, G., DeKoven, M., & Divino, V. M. (2021) · Leukemia & lymphoma/Leukemia and lymphoma · doi:10.1080/10428194.2021.1992761 · Cited by 22 · see citing works
Economic challenges of artificial intelligence adoption for diabetic retinopathy
Chen, E. M., Chen, D., Chilakamarri, P., Lopez, R., & Parikh, R. (2021) · Ophthalmology · doi:10.1016/j.ophtha.2020.07.043 · Cited by 21 · see citing works
Is It Time to Stop Paying for Computer-Aided Mammography?
Fenton, J. J. (2015) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2015.5319 · Cited by 19 · see citing works
Cohen, J. T., Lin, P., Sheinson, D. M., Wong, W. B., Wu, N., Yim, Y. M., & Ramsey, S. D. (2019) · Journal of Oncology Practice · doi:10.1200/jop.19.00241 · Cited by 15 · see citing works
Chen, J., Ferré, C. D., Ouyang, L., et al. (2021) · American Journal of Obstetrics & Gynecology MFM · doi:10.1016/j.ajogmf.2021.100508 · Cited by 15 · see citing works
Pietris, J., Lam, A., Bacchi, S., Gupta, A. K., Kovoor, J. G., & Chan, W. O. (2022) · Asia-Pacific Journal of Ophthalmology · doi:10.1097/apo.0000000000000565 · Cited by 15 · see citing works
Kvedar, J. C., Mittermaier, M., & Pritzker, J. (2022) · npj Digital Medicine · doi:10.1038/s41746-022-00743-1 · Cited by 14 · see citing works
dosReis, S., Saini, J., Hong, K., et al. (2022) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.5445 · Cited by 6 · see citing works
What is a premarket notification 510(k)?
Brindza, L. J. (1980) · Clinical Microbiology Newsletter · doi:10.1016/s0196-4399(80)80161-9 · Cited by 4 · see citing works
Disparate Impacts on Online Information Access during the COVID-19 PandemicPreprint
Suh, J., Horvitz, E., White, R. W., et al. (2021) · medRxiv · doi:10.1101/2021.09.14.21263545 · Cited by 4 · see citing works
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Artificial Intelligence in Oncology: Current Landscape, Challenges, and Future Directions
Lotter, W., Hassett, M. J., Schultz, N., Kehl, K. L., Van Allen, E. M., & Cerami, E. (2024) · Cancer Discovery · doi:10.1158/2159-8290.cd-23-1199 · Cited by 196 · see citing works
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Jain, S. S., Elias, P., Poterucha, T., Randazzo, M., Lopez Jimenez, F., Khera, R., Perez, M., Ouyang, D., Pirruccello, J., Salerno, M., et al. (2024) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2024.03.401 · Cited by 74 · see citing works
Mastrodicasa, D., van Assen, M., Huisman, M., Leiner, T., Williamson, E. E., Nicol, E. D., Allen, B. D., Saba, L., Vliegenthart, R., & Hanneman, K. (2025) · Radiology · doi:10.1148/radiol.240516 · Cited by 69 · see citing works
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Rosenthal, J. T., Beecy, A., & Sabuncu, M. R. (2025) · npj Digital Medicine · doi:10.1038/s41746-025-01674-3 · Cited by 59 · see citing works
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Hong, N., Whittier, D. E., Glüer, C.-C., & Leslie, W. D. (2024) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(24)00153-0 · Cited by 53 · see citing works
Abramoff, M. D., Dai, T., & Zou, J. (2024) · NEJM AI · doi:10.1056/aipc2400083 · Cited by 32 · see citing works
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- Authors
- Wu, K., Wu, E., Theodorou, B., Liang, W., Mack, C., Glass, L., Sun, J., & Zou, J.
- Affiliations
- Stanford University (US)
- University of Illinois Urbana-Champaign (US)
- IQVIA (United States) (US)
- ORCID
- Venue
- NEJM AI
- Publisher
- Massachusetts Medical Society
- Published
- 2024-01
- Volume
- 1
- Issue
- 1
- Pages
- AIoa2300030-AIoa2300030
- ISSN
- 2836-9386 (ISSN-L)
- OpenAlex
- W4388525108
- Cited by
- 103
- References
- 45
- Citations by year
- 2026: 30 · 2025: 47 · 2024: 25 · 2023: 1
- FWCI
- 4.11
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- NEJM AI (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Technology and Human Factors in Education and Health
- Keywords
- clinical adoption, CPT codes, insurance claims, device utilization, coronary artery disease, diabetic retinopathy, healthcare access equity, academic medical centers
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