The Fundamentals of Reimbursement in US Healthcare by Stryker’s Amanda Morrison was presented on November 12, 2025, at the Mayer Brown 2025 Utah Life Sciences Summit in Salt Lake City. Reimbursement in the U.S. healthcare system is the payment providers receive for medical services and products, primarily through government payers like Medicare, Medicaid, the VA, or private insurers. The process includes three main components: coding, which standardizes billing using codes like CPT; coverage, which determines if a service is medically necessary and included in a plan; and payment, which is the agreed-upon dollar amount for the service. Reimbursement models range from traditional fee-for-service to newer value-based models that focus on quality and outcomes. Understanding the fundamentals of reimbursement is important for life sciences companies because it impacts market access, revenue, and the ability of companies to ensure their innovative technologies and drugs reach the patients who need them.
