Developers of artificial intelligence (AI) and machine learning (ML) algorithms in medical radiology tend to think of regulatory approval as the primary hurdle to market, but there is also the question of how to pay for the use of these products. Public and private payers obviously hold the purse strings, but appealing to payers is still not always as straightforward proposition as some would like, reinforcing the notion that coverage and reimbursement still combine to serve as one of the highest hurdles to market for AI and ML.