Slot machine TITO system is a relatively newer feature in land-based casinos in the US. Instead of inserting coins in the coin hopper, you need to insert a ticket into these machines. And if you win, the machine will spit out a similar ticket. Hence, these machines are called Ticket-In-Ticket-Out (TITO) machines.
Each of the TITO slot machine tickets you purchase at the kiosk will usually have a barcode. It's for the machines to scan and determine the accurate amount of money. After you're done playing, all you have to do is go to the same Kiosk and insert your cash out ticket. The machine will pay you in real money accordingly.
This is a great feature that eliminates the painful process of carrying coins around the casino floor. And the use of automatic kiosks alleviates the pressure from casino cages where a lot of players line up to convert their coins.
MGM Group in the US is believed to be the initiator of this feature. It even created a consortium of manufacturers to join and experiment with the TITO slots. IGT, one of the largest slot manufacturers in the US, completed a field test of these machines in the year 2000.
Since then, the Nevada Gambling Commission approved the installation of the slot machine TITO system across the casinos.