Regulation · Regulation
US insurers say hospital AI billing tools added nearly $1 billion in costs
The Blue Cross Blue Shield Association says that as hospitals adopted AI coding tools, more patients were billed as complex, adding about $942 million for its member insurers from 2023 to 2025, with, it says, no sign of more treatment. It's the insurers' own analysis. Rating: Announced only.
How far away is this?
This is an insurer's press release about its own claims data. Insurers pay these bills, so they have a stake, and the full methods aren't published. The release doesn't include a response from hospitals.
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Where is it approved?
| Region | Regulator | Status | Notes |
|---|---|---|---|
| United States | FDA | Not applicable | Not a product; nothing to approve. |
| European Union | CE mark / EMA | Not applicable | Not a product; nothing to approve. |
| United Kingdom | MHRA | Not applicable | Not a product; nothing to approve. |
| Australia | TGA | Not applicable | Not a product; nothing to approve. |
Billing practice; not a product. "Register not searched yet" means we haven't searched that regulator's register; it doesn't mean the product is or isn't available. Approval in one country isn't approval in another.
What is it?
Hospitals get paid more for patients recorded as sicker. AI coding tools scan notes and lab results for extra diagnoses, like anaemia after bowel surgery, which can move a stay into a higher-paying category.
What's the evidence?
BCBSA estimates the rise in complex coding added $942 million in spending for BCBS companies between 2023 and 2025.[1]
Evidence stage: Announced only · #c1
About 70% of that, more than $650 million, came from secondary diagnoses, extra conditions recorded alongside the main reason for the stay.[1]
Evidence stage: Announced only · #c2
BCBSA says anaemia diagnoses rose without a matching rise in blood transfusions, and that more than 60% of hospital systems now use AI coding tools.[1]
Evidence stage: Announced only · #c3
What does it mean for me?
If you're in the US, check itemised hospital bills for diagnoses you don't recognise and ask about them. Insurers say these costs end up in premiums and out-of-pocket costs.
What could I ask my doctor?
- Can you explain the diagnoses listed on my bill?
These are general starting points, not a recommendation to choose any particular test or treatment.
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Change history
- : First published.
General information only, not medical advice. Talk to your doctor about your situation. AI-assisted source check. Not clinically reviewed.
References
- BCBSA analysis: how AI coding tools affect healthcare costs (24 Sep 2026). bcbs.com (2026). Press release (claim). https://www.bcbs.com/about-us/association-news/bcbsa-analysis-ai-coding-tools-affects-healthcare-costs
Publisher shown as the website hosting each source. Dates are given where the source label includes them.