Everyone's piling onto Software as a Medical Service (SaMS), and related terms. AMA CPT has been working on its Appendix S software coding paradigms. CMS in July offered radical changes to come, beginning with a new acronym, SaMS. Now the advisory body MEDPAC piles on.
Here's how Google Gemini summarizes some new MEDPAC initiatives:
- The MEDPAC agenda specifically highlights ongoing work to analyze Medicare’s payments for Software as a Medical Service (SaMD) and Prescription Digital Therapeutics (PDTs).
- MedPAC breaks this digital health framework into two distinct buckets:
- SaMD / Software as a Service (SaaS): Algorithm-driven software designed to aid clinicians in diagnostic decisions or clinical assessments (e.g., AI image analysis, computational pathology, diagnostic algorithms).
- While Medicare has paid for some SaaS tools under fee schedules or inpatient new technology add-on payments (NTAP), MedPAC continues to question whether current relative values accurately reflect true costs.
- Prescription Digital Therapeutics (PDTs): Patient-facing software applications delivered via personal devices to treat illness or injury. Because most PDTs do not fit into traditional Medicare benefit categories (like Durable Medical Equipment), coverage remains severely limited.
- (MEDPAC is not using CMS's latest summer-2026 terminologies.)
See the MEDPAC agenda here:
https://www.medpac.gov/medpacs-analytic-agenda-for-the-2026-2027-meeting-cycle/