Start a New-Billing-Code Market-Unlock Advisory for AI Diagnostics

1. 1

   Master the billing-code creation and coverage process

   The core expertise is how new CPT codes are created, valued, and covered: the CPT editorial process, the difference between a code existing and payers actually reimbursing it, and how a code like 92229 for AI retinal screening moved a category from unreimbursed cost to billable revenue. You need to understand both the mechanics and the timeline, which is often multi-year. This depth is the entire value proposition. Study real code-creation cases in detail.

2. 2

   Package the new-code-as-catalyst pattern

   The transferable insight is that a dedicated reimbursement code can be the single catalyst that unlocks commercial viability for an AI diagnostic category, and the same pattern applies whenever a new AI diagnostic technology needs a realistic path to adoption rather than remaining a research curiosity. Turn that pattern into a repeatable diagnostic: does this technology have a viable code path, and what is the strategy and timeline to get there. A clear framework is what makes the advisory sellable. Build the methodology deliberately.

3. 3

   Position distinct from generic reimbursement consulting

   A generic device reimbursement and market-access consultancy already exists in the market; your niche is specifically the billing-code strategy for AI diagnostics as the market-unlock catalyst. Sharpen the positioning so buyers understand you solve the exact question that decides whether their AI ever gets adopted. The specificity is the differentiator. Do not blur into general consulting.

4. 4

   Sell to AI diagnostic companies at the right moment

   The buyers are AI diagnostic companies, investors doing diligence, and health systems evaluating adoption, and the highest-value moment is early, when a company is deciding whether and how to pursue a code before sinking years into a product with no reimbursement path. Reach them through content, health-tech networks, and referrals. Timing the engagement early is where you add the most value. Build relationships in the AI diagnostic and investor community.

5. 5

   Deliver strategy, not promises

   Your deliverable is a realistic assessment and strategy: the code landscape, the path and timeline to a code or coverage, the interim options, and the honest odds, never a guarantee that a code will be created or that revenue will follow. Reimbursement outcomes depend on bodies you do not control, and the advisory has to say so. Honest, well-reasoned strategy is what earns repeat engagements and referrals. Sell clarity, not certainty.

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