Medicare will pay up to $137.53 per case in 2027 for BriefCase‑Triage
Radiology Business reported Medicare will pay a maximum of $137.53 per case in 2027 for BriefCase-Triage. Holland & Knight said hospitals will be eligible for NTAP reimbursement for use of Aidoc’s CARE Body CT Multi-Triage beginning Oct. 1, 2026, with supplemental payments continuing for three years.
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Key facts, context, and what it means.
Key takeaways
Radiology Business reported Medicare will pay a maximum of $137.53 per case in 2027 for BriefCase-Triage.
Holland & Knight said CMS approved an NTAP designation for Aidoc’s CARE Body CT Multi-Triage, with hospitals eligible for NTAP reimbursement beginning Oct. 1, 2026, with supplemental payments continuing for three years.
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Radiology Business reported Medicare will pay a maximum of $137.53 per case in 2027 for BriefCase-Triage. The outlet described Aidoc’s CARE (Clinical AI Reasoning Engine) Multi-Triage CT Body tool as using AI to analyze CT images and flag potentially urgent findings such as appendicitis or a bowel obstruction.
The payment sits inside the New Technology Add-On Payment (NTAP) program. Holland & Knight reported CMS approved an NTAP designation for Aidoc’s CARE Body CT Multi-Triage tool on Aug. 13, 2026, calling it the first time the agency has granted NTAP designation for an AI-enabled diagnostic tool.
What CMS actually approved, and what it pays
NTAP is a supplemental inpatient payment intended to make early adoption of qualifying technologies less financially risky, per Holland & Knight. The program is structured around three criteria: the technology must be new, it must be costly enough that the standard payment is inadequate, and it must represent a substantial clinical improvement over existing options.
Under the approved methodology, the add-on payment is the lesser of 65% of the technology’s cost or 65% of the amount by which a case’s cost exceeds the standard Medicare Severity Diagnosis-Related Group (MS‑DRG) payment, according to Holland & Knight.
Radiology Business reported Medicare will pay a maximum of $137.53 per case in 2027 for BriefCase-Triage. The outlet also reported the American College of Radiology summarized the figure as representing about 65% of the average cost of the technology.
The tool’s scope is broad, so billing discipline becomes the gating factor
Aidoc’s CARE Body CT Multi‑Triage analyzes contrast and non-contrast CT imaging of the chest, abdomen, and pelvis, and is designed to help prioritize cases with time-sensitive findings, Holland & Knight reported. Radiology Business described example urgent findings the system flags, such as appendicitis or bowel obstruction.
The key operational point is that payment depends on reliably flagging and coding qualifying cases. Radiology Business reported that Medicare will use ICD‑10‑PCS procedure code XEZ5XKC to mark eligible add‑on cases that involve the AI product, a code described as computer-aided triage and notification for imaging abnormalities in CT of chest, abdomen, and pelvis (new technology group 12).
Holland & Knight said hospitals should confirm they meet eligibility rules and align billing practices with CMS requirements to stay compliant when adopting NTAP-designated technologies.
A narrow window with real dollars attached
Holland & Knight said that starting Oct. 1, 2026, hospitals can receive NTAP reimbursement for using Aidoc’s CARE Body CT Multi-Triage technology, with supplemental payments continuing for three years.
Compliance and governance work starts before go-live
Holland & Knight said health systems should review eligibility, billing practices and CMS requirements when adopting NTAP-designated technologies. The firm also said systems should ensure compliance with HIPAA and state laws governing the use of AI programs in healthcare settings.
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