Characterizing the clinical adoption of medical AI through U.S. insurance claims

There are now over 500 medical AI devices that are approved by the U.S. FDA. However, little is known about where and how often these devices are actually used after regulatory approval. In this paper, we systematically quantify the adoption and usage of medical AI in the U.S. 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 examine a comprehensive nationwide claims database of 16 billion CPT claims between 1/1/2015 to 6/12023 to analyze the prevalence of medical AI based on submitted claims. Our results indicate that medical AI 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, medical AI usage is moderately over-represented in higher-income zip codes and metropolitan areas. Our study sheds light on the current landscape of medical AI adoption and usage in the U.S., underscoring the need to further investigate barriers and incentives to promote equitable access and broader integration of AI technologies in healthcare. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This research is supported by funding from the Chan-Zuckerberg Initiative. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes