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To Code or Not To Code

To Code or Not to Code is one of the most consequential reimbursement decisions a digital health startup will make, and it rarely has a simple answer. Reimbursement is not just a “code question.” It is a market access question. Coding, coverage, and payment are interconnected, highly regulated, and often shaped by setting of care, payer type, and state-by-state policy variation. In some cases, an existing code can accelerate adoption because it matches how providers already bill and get paid. In other cases, pursuing a new code can take years, require significant evidence, and still fail to produce sustainable access or revenue. In this recorded webinar, Demi Radeva (CEO & Chief Strategist, Akros Advisory) and Rebecca Lanquist (Director of Reimbursement Consulting, Horizon Reimbursement Consulting) walk through how to think about reimbursement pathways for digital health and health technology solutions, including when traditional coding makes sense and when non-traditional routes may be faster, more practical, or more financially viable. You’ll learn: How coding, coverage, and payment fit together in the traditional model Why “having a code” does not automatically mean access or a viable business How reimbursement varies by payer, employer, and state (with a doula care case study) What product and policy nuances can make or break coverage (including the Dexcom Medicare example) A practical decision framework to assess existing codes, new code potential, and alternatives Hosted by Akros Advisory We help digital health and healthcare organizations navigate payer strategy, reimbursement, and go-to-market execution with rigor, realism, and practical tools.