The AMA’s Current Procedural Terminology (CPT) Editorial Panel has accepted a new Category 1 CPT code for retinal imaging with automated point-of-care.
A major barrier to the widespread use of digital therapeutics (DTx) is the limitation or lack of reimbursement by public and private insurance providers, according to GlobalData. DTx can be used to prevent, manage, or treat diseases across diverse indications, particularly chronic conditions, such as diabetes, respiratory diseases, and mental health conditions and neurological disorders.
But such limitations could be changing soon because of a recent decision by the American Medical Association's (AMA) Current Procedural Terminology (CPT) Editorial Panel to create a Category 1 CPT code for retinal imaging with automated point-of-care, which includes IDx-DR, an FDA-cleared autonomous AI system that detects diabetic retinopathy without the need for physician interpretation. This new code, submitted by the American Academy of Ophthalmology, with the support of IDx, facilitates correct billing of IDx-DR.