Key takeaways from this episode

• Build the reimbursement strategy into a new technology at the development stage, not after launch. At the AUA Innovation Nexus, PRS advised early-stage companies to determine now whether their product fits an existing CPT, HCPCS Level II, APC or DRG pathway, or whether the case must be made on practice payback, return on investment and time savings instead.
• Without a workable financial story, a good technology will not reach urology practices or patients. Practices operating on lower margins can no longer afford to experiment, so the reimbursement pathway needs to be identified sooner to shorten the time from innovation to adoption.
• Evaluate new technology on time saved, not only on what it pays. Practice income depends on what you do and how many times you do it, so delegate everything that does not require the physician and adopt tools that make each function more efficient.
• Do not implement what you saw at the AUA on the Tuesday you get back. Plan the office flow with your team, secure the support mechanisms, and test sustainability so the whole practice, not one physician or one patient, benefits.
• Give office managers and billing and coding staff the product information up front. They are the ones who operationalize a new service, and technology vendors are starting to favor practices that plan adoption with everyone's participation.
• Expect faster development cycles and more new options each year. AI, manufacturing and platform technologies are shortening timelines, so practices need a repeatable process for vetting and rolling out new services.
• The AUA Innovation Nexus has grown to 42 pitching companies and 500 attendees, with reimbursement now a main-stage topic. Dr. Steve Kaplan started the program about four years ago with 10 companies; Boston Scientific and Cook were among the acquirers present.

Transcript

Lightly edited for readability; timestamps mark where each speaker turn begins in the recording. UCR 289, recorded May 2026, with Scott Painter, Mark Painter and Dr. Ray Painter of PRS Network.

Live from the AUA in Washington, DC

[00:00] Scott Painter: On this episode: live from the AUA. Welcome to episode 289 of the Urology Coding and Reimbursement Podcast. I'm your host, Scott Painter, with my co-host Mark Painter and Dr. Ray Painter. On today's episode, Mark and I are live from the AUA meeting in Washington, DC, and Ray is live from Denver, Colorado. Ray, you've been to a ton of these AUA meetings and have experienced them in many different capacities. Do you want to share a little about your experience, not only from the clinical side but also from the coding and reimbursement side, and how you view things?

[01:00] Dr. Ray Painter: Well, Scott, it's always fun to go to the AUA and see old friends and hear what's new. For the first 30 years of my practice, what's new was mainly devoted to the clinical. The last 30 years were mainly devoted to coding, reimbursement and new technology, and how we do. So it was always enjoyable, always something new, always something to learn.

[01:38] Scott: Very true. There's so much going on here that it's hard to take it all in, and it's always exciting to see everything. Mark, do you want to share a little about our experience, what's going on and what we've done so far?

The Innovation Nexus program and early-stage reimbursement strategy

[01:57] Mark Painter: Yeah, Scott. We came in a day early this year to be participants in the Innovation Nexus program. This is a program that has been driven by Dr. Steve Kaplan, set up about four years ago. They started with 10 early-stage companies making a pitch on what their ideas were and where they were in the business development process. There were some investors involved to talk about the journey they've seen with various companies, and this has grown very quickly under Dr. Kaplan's guidance. Yesterday we had 500 attendees, and 42 companies were given the opportunity to pitch in front of groups, investors, advisors and mentors in the space. The AUA has really created a community and a support network for new companies to help them reach the finish line faster, which essentially means allowing physicians to deliver their ideas as a service, a product, or some type of support to urology practices across the United States. So it was great to see.

Scott and I didn't get to see all the pitches this year because we were talking to groups about what they needed to consider in the development stage relative to reimbursement: whether they needed to look at codes, or at payback and return on investment to practices, or time savings. It was exciting to look at each of these ideas or products, depending on which stage they were in, and talk through some of those considerations. I think it was eye-opening for them as well as for us to think about how important that overall strategy is at every stage of the development or life of a company. Some of these folks are looking for several million dollars to help bring their product to market. Some are looking for fewer dollars to get into the market. Many are looking at the transitional side and how to work with some of the bigger companies who are also here, like Boston and Cook, who are on the acquisition side once a product becomes viable and fits their portfolio. They were all very good at sharing what they were looking for and how it all works.

One of the main exciting points in all of this is the number of urologists involved. I've mentioned over the years that urology is one of my favorite specialties for many reasons, mainly because I grew up with it and the sense of humor, but also because of the entrepreneurial bent and the forward thinking of urologists in general, in both clinical and business approaches to healthcare within our market system, which is as complex as anything. That was the other part that was very evident yesterday, as we were trying to explain to folks who are mainly financial and business people what CPT, ICD-10, HCPCS Level II, APCs, DRGs and the alphabet soup we live in day to day mean when we apply their business ideas to a practice. Anything we implement, we have to figure out how it fits into the operational and financial parts of the practice in addition to the clinical, because clinical is the base, and everybody's focus is solving problems in a new and better way. Some of the technology was space age a few years ago: nanobots, all sorts of AI. But in the end, the problems that exist are still similar and familiar to urologists: cancer, BPH and all of those things.

So it's exciting to walk through this, and now we're getting ready for the next couple of days to walk through the exhibit hall, the science and technology hall, and see the products that have actually made it to market. We'll talk to folks about reimbursement and where they should be, have discussions about whether their current products fit within existing codes, what the regulations are, what the potential is long term, and whether they can survive the business pathway to the end goal they're searching for, given that our reimbursement system doesn't always adapt as quickly as we would like. Financially, with lower margins, it's not as easy for practices to just experiment anymore. So it's exciting, and there is a lot of promise. But I have to say that the real underlying piece of the AUA I enjoy is the collective energy and the person-to-person interaction at these meetings. There are a lot of international folks we don't get to interact with, but even their energy adds to the overall feel.

And then I get to close things out on Monday. I'm teaching a course with my partners, Dr. Vineeta Simachand, Dr. Pablo Santa Maria, Dr. David Kainz and Dr. Waleed Hassan, on AI and its application for KPIs, and some of the ways they've leveraged, or are starting to leverage, AI to improve their operational flow or their revenue cycle, which is where I get to spend most of my time. That will be exciting as well. So it's full circle, all of it looking toward the future. But again, it's that collective energy, seeing old friends and meeting new ones, that's hard to substitute.

Reimbursement moves front and center for new technology

[09:09] Scott: I agree. Mark, I also wanted to point out that we've been to the Nexus presentation the last couple of years, and there really wasn't much discussion of reimbursement. This year it was front and center. There were a lot more discussions in the main presentation about reimbursement, and that is exciting, because maybe we'll see technologies come through with a path to reimbursement that's much shorter than we've seen in the past, as these companies work with us and with others sooner to figure out the reimbursement strategy and identify the reimbursement pathway. I found that one of the encouraging signs. All this technology is great and extremely important to patients, but without a good reimbursement and financial story, these great technologies won't reach the urology practices. That's where we want to lend our support and our help: to see if we can make that reimbursement or financial story fit sooner, so the technology gets to the practice and to the patient more quickly.

I wanted to switch gears a little with Ray. Ray, one of the things you and Mark have always taught is that reimbursement, office efficiency and the financial health of your practice are not just about coding and the amount you get paid for what you do, but also how you use your time in the office. Can you talk a little about that? We're seeing some of these new technologies not offer a great financial story from the reimbursement side, but rather from the time savings side.

Time is money: efficiency, delegation and adopting technology

[12:10] Ray: Yes. If you look at the big picture, we've always said time is money. Take a look at your bottom line: it depends on what you do and how many times you do it, and what you do and how many times you do it depends on how efficient you are. So we've always pushed delegation, so that you do only the things you need to do and let somebody with a lower price tag do the rest. That also applies to technology and the support you get with all the functions you do. So it is important to adopt new technology as it comes along.

[13:07] Scott: Mark, you talked a lot about the excitement that comes back from those attending the AUA, and how that can be a disruption in the practice, or how you can really leverage it. Do you want to share what you talked about and how that discussion came about?

Bringing new ideas home without disrupting the practice

[13:39] Mark: Sure. As we were talking to some of these groups in the Nexus, one of the things we emphasized is something our UPTP group has done a great job of solving, but not all practices have. The AUA introduces physicians to a number of new things: new solutions to problems, new EHRs, new options and opportunities throughout the practice to save time, increase efficiency or improve patient treatment. Sometimes these docs come in all gung-ho and fully intend to implement these new things in the office on Tuesday or Wednesday of the week they get back, without really talking it through with their team and the support mechanisms they need, without building the office flow, without looking at the sustainability of it.

That's where we look at groups, and I think the technology partners are also going to start looking for clinical partners who take the time to plan, look at things in the context of their practice, and truly drive these new things into the office with everybody's participation and support. That's a piece of the game that has been missed in the past, and we've definitely heard from office managers and billing and coding folks over the years that the docs aren't giving them all the information up front. I think everyone is getting better at this, and it's going to be an important partnership with all this new stuff, because the development timelines are shorter. We're seeing more new options faster than in the past. Part of it is that things are being developed faster: you can look at it from the AI standpoint, from manufacturing options, from the global economy and how moving things from one country to another works in some places and not others, and from the leaps and bounds we've seen in platform technologies that can be built upon and added to. All of this is exciting but can also be confusing, and we're really appreciative of the staff and the folks we talk to who are responsible for operationalizing it, so it's not just one patient who gets the new treatment, or one physician in the practice who gets the time savings, but it's put into the practice in a way that everybody can capitalize on it and improve the entire practice and the experience for your patients.

Sponsor and final thoughts

[16:54] Scott: All right, let's wrap this episode up. We want to thank ModMed for supporting this episode. If you're in the market for an EHR or a practice management system, go to modmed.com/prsnetwork for specials for our listening audience. Okay, let's get some final thoughts. Mark, what are your final thoughts?

[17:16] Mark: I think I've been pontificating about my thoughts all episode, so I'll keep my final thoughts very short. If you see us walking around the AUA, say hi. We're definitely going to absorb what we can while we're here and learn what we can, and if you see things we missed, let us know, whether it's here or later down the road.

[17:41] Scott: Ray, final thoughts?

[17:46] Ray: I think this is a very exciting time. Was it Yogi Berra who said, "It's deja vu all over again"? At any rate, when we first got into trying to help docs understand the new coding and billing system back in the '90s, we worked closely with the AUA. At one time we were able to get a grant that allowed them to start the practice management group they had, which was very successful for a while. That waned over the years, but now with the Nexus program it's good to see Mark, Scott and PRS again working with the AUA on coding and reimbursement. I want to give a big shout of thanks and congratulations to Dr. Kaplan for being able to shepherd this through and get it going. It's nice to see the AUA back involved in helping with the business side of healthcare.

[19:04] Scott: All right. That's all we have today. Thank you all for listening. Take us out, Ray.

Ray: Happy coding.

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