By Margaret Hampton at Brownstone dot org.

Healthcare in the United States is in a death spiral. Costs continue to rise, chronic diseases consume 90% of healthcare spending, and millions of Americans feel trapped in a system that often limits choice. Patients increasingly want insurance for a broader spectrum of care — from functional/integrative medicine, to preventive, and more holistic approaches — yet insurers frequently fail to recognize these services due to a lack of billing codes. The result is a healthcare environment where innovation is constrained, patient autonomy is reduced, and effective alternatives to conventional medicine remain invisible to insurers and financially inaccessible to most patients.

Two forces could fundamentally change the US landscape. ABC codes for non-allopathic caregivers and Health Savings Accounts (HSAs). Together, they provide a powerful framework for health freedom and empower Americans to make personalized healthcare decisions.

Healthcare systems (insurers and other payers) only reimburse what is coded and billable. The lack of codes for all healthcare options started in 1983 when the US Department of Health and Human Services (HHS) and the American Medical Association (AMA) agreed that HHS would only use the AMAs codes to process Medicare and Medicaid claims.

In 2002, HHS mandated use of the AMA's codes for filing electronic claims. ABC codes were mentioned as an option but not adopted and the AMA currently has a monopoly on billing codes.

In 2003, HHS provided an exception to test ABC codes as a standard for two years. Alaska Medicaid successfully paid for over 2 million ABC-coded claims filed electronically. Yet government reviewers of the exception data advised HHS in 2005 not to adopt ABC codes. The cost savings of using non-physician practitioners and functional/integrative care remained invisible due to this decision, and our healthcare spending has continued to skyrocket. Chronic disease drives nearly 90% of healthcare expenditures, yet our healthcare system remains largely structured around acute-care treatment.

As a result, patients frequently experience long wait times and expensive interventions only after disease has advanced. Integrative and alternative practitioners offer a different approach — one centered on prevention and addressing root causes rather than managing symptoms alone.

By intervening earlier and promoting healing, they can improve outcomes while reducing the need for costly medical interventions. Existing studies of nurse practitioner and advanced practice nurse care demonstrate cost reductions ranging from approximately 6% to over 30% compared with physician-led care while maintaining similar outcomes in many settings. ABC Codes provide a mechanism to identify, document, and measure those lower-cost care pathways across a much broader healthcare workforce.

X12, the standard for all electronic transactions, created the ability for ABC Codes to be transmitted within certain healthcare electronic transaction standards.

In practical terms this makes it possible to use ABC codes in electronic claims without HHS approval. This establishes a broader, more inclusive healthcare coding framework capable of documenting services that have historically been invisible to traditional reimbursement systems.

By providing standardized codes for a much wider range of healthcare services, practitioners and payers gain the ability to track outcomes, analyze utilization, and understand the real-world impact of therapies that patients are already using every day. The data from ABC coded claims can uncover how to create a more affordable healthcare system.

ABC Codes will help us to solve the chronic disease crisis. Conditions such as diabetes, obesity, autoimmune disorders, cardiovascular disease, anxiety, depression, and chronic pain are not being resolved using conventional medicine. They require sustained lifestyle support, prevention strategies, nutritional counseling, beh...