Reimbursement TF Update: Setting the Stage for DP and AI Reimbursement

Learning Objectives

1. Understand the key priorities/activities of the DPA reimbursement task force.
2. Better understand the current and evolving reimbursement landscape for DP and AI.
3. Gain awareness of how the DPA is working with allied organizations to move reimbursement for DP and AI forward.

While digital pathology adoption is increasing and AI image analysis continues to show impressive potential to impact the practice of pathology, the overall return on investment (ROI) for digital pathology implementation remains a significant challenge. With an increasing number of DP solutions being cleared by the FDA for IVD applications, the lack of reimbursement is quickly becoming the most significant barrier to DP adoption.

Category III codes introduced in 2023 for tracking of whole slide imaging have been difficult to implement and may not be generating the evidence required to move forward quickly with significant change. Furthermore, to date, these codes are focused solely on digitization in the lab and do not provide for tracking or reimbursement for emerging AI image analysis solutions developed for digital pathology. 

The DPA Reimbursement Task Force has a mission to "Define and shape the pathway to reimbursement for digital pathology solutions enabling broad market access and delivery of value to patients and stakeholders." To this end, we have identified key strategic initiatives to enable the DPA to play a leading role in advocacy for a pathway to reimbursement for AI solutions. In addition, the task force is working through blog posts and webinars to educate the DPA members on the current state of reimbursement for DP and the opportunities ahead. 

This session will provide an update on the key work of the task force and provide a detailed look into the framework for DP AI reimbursement that the task force is pursuing.