AI billing tools are adding pressure to health costs
PwC says AI documentation tools can support higher medical billing codes, adding to projected health cost growth in 2027.
By Sofia Marchetti · World Affairs Correspondent
3 min read
Artificial intelligence is emerging as a new force pushing health care costs higher, according to a PwC report. The finding matters for patients and employers because AI systems billed as efficiency tools are also helping providers document visits in ways that can support larger insurance payments.
PwC projects health care costs could rise 9% in 2027, matching the rate it cites for 2026 and marking the highest level since 2010-11. The firm named AI as one of five possible reasons for the increase.
The report points to AI note-taking and documentation tools used in clinical settings. PwC said those systems can record more detail about diagnoses and complications than a busy clinician might enter manually.
Those details can affect medical coding. A billing code is the standardized label providers use to tell insurers what condition was treated and how severe it was. More specific documentation can support a higher-severity code, which can pay more, even when the patient’s care has not changed, according to PwC.
Billing codes draw scrutiny
A Blue Cross Blue Shield analysis cited by Fortune found a sharp rise in one maternity-related code: acute posthemorrhagic anemia in new mothers. The analysis found that some hospitals used that code in 12.3% of maternity admissions in 2025, up from 4% in 2022.
Blue Cross Blue Shield also found that blood transfusions, a common treatment for that condition, changed little during the same period. The insurer said greater coding intensity added $22 million to maternity spending at the hospitals it studied over three years.
STAT reported that an audit of the hospital system with the largest increase in that code found fewer than 20% of the cases met the clinical criteria for the diagnosis. Fortune reported that the increase in higher-intensity coding came as hospitals expanded their use of AI in billing-related work.
The pattern shows how AI can affect costs through administrative systems, not only through direct patient care. In this case, the technology may help providers capture billable detail that would otherwise be missed or grouped under broader codes, according to PwC.
Older cost pressures remain larger
PwC ranks AI as the leading new pressure in its report. Labor and supply expenses still account for more of the overall cost increase, one of the report’s authors told Healthcare Dive.
The same technology could also reduce costs in other uses. Fortune cited Morgan Stanley analysis suggesting AI may lower expenses over time by automating hospital administrative work or helping detect illnesses earlier.
For now, PwC’s report adds a caution to the health care industry’s AI push. The technology may make paperwork faster and more detailed, but insurers and patients could see some of those gains show up first as higher bills.
This story draws on original reporting from Fortune.