For two years, nurses have battled artificial intelligence mostly at the bargaining table. A proposed set of AI billing codes has now opened a new front: how the technology is reimbursed.
The American Medical Association is pushing to create billing codes for autonomous AI — “clinically meaningful algorithmic analyses,” or CMAA — that would let hospitals bill for certain AI-generated clinical analyses performed without physician work at the point of care. The proposal has drawn concern from nursing leaders, who point out that registered nurses still have no standalone billing code of their own.
The objection centers on the precedent the codes set. Bedside nursing is one of hospitals’ largest labor investments, yet registered nurses have no standalone Current Procedural Terminology, or CPT, code; their work is folded into a hospital’s room charge rather than billed on its own. If the framework advances, AI would get a direct payment pathway nurses never have.
“If the AMA can build an entirely new billing category for AI, it can build one for nursing,” Rebecca Love, MSN, RN, founder of the Commission for Nurse Reimbursement, said in a July 16 nurse.org article. “Nursing will remain a cost, AI will become a revenue stream, and the implications will be devastating to nursing.”
The billing fight is the latest sign that nursing’s resistance to AI policies is both widening and climbing to bigger stages. What began as scattered protests and contract clauses over staffing and scheduling has grown into a national campaign spanning patient safety, job security and now reimbursement policy.
In October 2024, nurses at 17 hospitals owned by Nashville, Tenn.-based HCA Healthcare across six states ratified contracts giving them a say in how AI is implemented — an early win at one of the nation’s largest nursing employers. Three months later, thousands of nurses marched in Washington, D.C., Texas and California demanding AI safeguards alongside safe staffing.
The venues have grown more prominent since. Hundreds of workers at Oakland, Calif.-based Kaiser Permanente rallied in Honolulu in August 2025 over AI job protections tied to a contract covering more than 60,000 staffers. And on July 13, California nurses protested outside the American Hospital Association’s Leadership Summit in Denver. The protest was timed to the eve of a fireside chat by Kaiser Chair and CEO Greg Adams on moving technology “from pilots to everyday practice.”
The National Nurses Association, the country’s largest nurse union with nearly 225,000 members, surveyed more than 2,300 registered nurses in 2024 about this topic. Sixty percent said they did not trust their employer to put patient safety first when deploying AI, and many reported their own assessments of patients did not match what AI tools concluded.
Health systems have largely framed AI as a complement rather than a replacement. In its statements, Kaiser has said AI “automates tasks, not jobs” and that it intends to keep discussing the technology’s use through collective bargaining.
Richard Frank, MD, PharmD, a member of the AMA’s CPT Editorial Panel, said autonomous AI remains under physician oversight: “We’re a long way from robots running off with patient care.”
The AMA is accepting comments on the coding framework through Aug. 10, and CMS is taking comments on its proposed 2027 payment rule — which will shape how AI services are reimbursed — through Sept. 14. Both give healthcare workers a formal channel to press a question to executives: If an algorithm’s clinical work can be billed, why can’t a nurse’s?
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