US SB1399

Amends Medicare's hospital outpatient prospective payment system to require algorithm-based healthcare services (AI, machine learning, and similar software-based clinical tools cleared by the FDA) be assigned to new technology ambulatory payment classifications starting January 1, 2026

Payment classifications must be based on manufacturer-submitted costs including invoice prices, subscription fees, clinical staff time, overhead, and other service delivery costs

Services must remain in the new technology payment classification for at least 5 years before being reassigned, and only after adequate claims data exists

Expands eligibility criteria so algorithm-based services performed concurrently with, adjunctive to, or as part of underlying procedures can qualify for new technology classification if they require additional resources

Codifies the software-as-a-service payment policy from the November 2022 CMS final rule (87 Fed. Reg. 71748), applying retroactively to services provided on or after January 1, 2023