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Policy brief: ambient AI scribes and the coding arms race

Dai T, Kvedar JC, Polsky D

NPJ digital medicine, 2025

Abstract

Ambient AI “digital scribes” are rapidly moving into routine practice, easing documentation burden and physician burnout. Early evidence suggests these tools can increase billing and risk-adjustment coding intensity, prompting payer responses such as downcoding and risk-score recalibration. This Policy Brief contrasts their implications in fee-for-service and Medicare Advantage models, notes relevance for systems blending encounter-based and capitated payment, and outlines steps to preserve value without fueling a coding arms race.

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