Health Tech Investment Act

Summary#

This bill changes how Medicare pays for certain outpatient services that use algorithms or artificial intelligence. It amends section 1833(t) of the Social Security Act.

For covered outpatient department (OPD) services furnished on or after January 1, 2026, that are algorithm-based and are assigned to a new technology ambulatory payment classification (new technology APC) or have been in such an APC for less than 5 years, the Secretary of Health and Human Services must:

  • assign the service to a new technology APC based on cost information submitted by the manufacturer, including invoice prices, subscription prices, clinical staff, overhead, and other related costs;
  • adjust the APC payment as needed based on that information; and
  • not remove the service from the new technology APC until there is adequate claims data to reassign it and the service has received payment under the APC for at least 5 years.

The bill also directs the Secretary to change the application process and eligibility criteria for the new technology APC so that algorithm-based services that are distinct but provided alongside or as part of other services and that require extra resources can qualify. The bill defines "algorithm-based healthcare service" as a service delivered through an FDA-cleared or -approved device that uses artificial intelligence, machine learning, or similar software to produce clinical outputs for a physician or practitioner.

Section (b) directs the Secretary to apply a hospital outpatient prospective payment policy for software-as-a-service (SaaS) described in a November 23, 2022 final rule, effective for services provided on or after January 1, 2023.

The bill was introduced in the House on November 20, 2025, by Representative John Joyce and several cosponsors, and was referred to the Committee on Energy and Commerce and the Committee on Ways and Means.

What it means for you#

  • Manufacturers: The bill requires manufacturers of FDA-cleared or approved algorithm-based services to submit cost information (invoices, subscription prices, staff, overhead, and other costs) in a form specified by the Secretary to support assignment to a new technology APC.
  • Hospitals and outpatient providers: Services using covered algorithm-based devices may remain in a new technology APC and receive APC payments set using submitted cost data. Providers should expect the classification to remain in place at least until the service has had APC payments for 5 years, unless the Secretary finds adequate claims data for reassignment.
  • Clinicians and patients: The bill defines which algorithm-based services are eligible for special APC treatment. The text does not describe changes to clinical use, coverage rules, or patient out-of-pocket costs.

Expenses#

No publicly available information on total federal costs or budget estimates is included in the bill text provided. The bill directs the Secretary to apply an existing SaaS payment policy effective January 1, 2023, but it does not include numeric cost or savings figures.

Proponents' View#

No publicly available information.

Opponents' View#

No publicly available information.