American College of Cardiology

DECEMBER 14, 2023

The Centers for Medicare and Medicaid Services (CMS) has paused the Appropriate Use Criteria (AUC) program for advanced diagnostic imaging and rescinded any current regulations, according to the 2024 Medicare Physician Fee Schedule (PFS) final rule.

CMS 57

CMS Medicare Medicaid Article 57

DAIC

OCTOBER 16, 2024

15 , 2024 — Four of the seven Medicare Administrative Contractors (MACs) have released final local coverage determinations (LCD) for AI-Coronary Plaque Analysis (AI-CPA). tim.hodson Wed, 10/16/2024 - 12:36 Oct. The four contractors for the U.S.

CMS 52

CMS Medicare Plaque Chest Pain 52

American College of Cardiology

MARCH 21, 2024

The Centers for Medicare and Medicaid Services (CMS) has increased the Medicare Physician Fee Schedule (PFS) conversion factor by 1.68% – from $32.74 for services rendered Jan. 1 through March 8 to $33.07 for services rendered March 9 through Dec.

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CMS Medicare Medicaid Article 43

DAIC

JANUARY 30, 2025

This model aligns with the 2025 Centers for Medicare & Medicaid Services (CMS) initiatives, including value-based care and age-friendly health system measures, while supporting our mission to deliver improved outcomes and quality care for every patient."

Stroke 52

Stroke Strokes Outcomes Quality of Life 52

CardiacWire

MARCH 24, 2024

Less than two weeks after Novo Nordisk’s weight-loss drug Wegovy gained expanded FDA approval for cardiovascular event risk reduction, CMS issued a new Medicare Part D guidance that allows coverage of obesity drugs for senior patients with “an additional medically accepted indication”… like cardiovascular disease.

Medicare 59

Medicare Obesity CMS Medicaid 59

American College of Cardiology

JULY 16, 2024

The Centers for Medicare and Medicaid Services (CMS) released the proposed 2025 Medicare Physician Fee Schedule (PFS) on July 10, addressing Medicare payment and quality provisions for physicians in the coming year. Under the proposal, physicians will see a decrease to the conversion factor of 2.80% on Jan.

Medicare 43

Medicare CMS Medicaid Article 43

American College of Cardiology

AUGUST 7, 2024

The Centers for Medicare and Medicaid Services (CMS) released the Fiscal Year (FY) 2025 Inpatient Prospective Payment System (IPPS) Final Rule on Aug. 1, including a 2.9% increase in operating payment rates for general acute care hospitals, representing a 3.4% increase in the hospital market basket with a 0.5%

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CMS Medicaid Medicare Inpatient 43

American College of Cardiology

AUGUST 22, 2024

The Centers for Medicare and Medicaid Services (CMS) summarized a recent billing edit change in the 2025 Hospital Outpatient Prospective Payment System (OPPS) proposed rule, which fixes an issue that previously prevented hospitals from reporting costs for cardiac computed tomography (CT) as cardiology services.

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CMS Medicaid Medicare Outpatient 40

American College of Cardiology

APRIL 12, 2024

The Centers for Medicare and Medicaid Services (CMS) released the Fiscal Year (FY) 2025 Inpatient Prospective Payment System (IPPS) proposed rule, proposing a 2.6% increase in operating payment rates for applicable hospitals. This represents a 3% projected increase in the hospital market basket update with a projected 0.4%

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CMS Hospital Medicaid Medicare 43

American College of Cardiology

MARCH 11, 2024

The Centers for Medicare and Medicaid Services (CMS) announced on March 9 a new opportunity to request advanced Medicare payments for clinicians impacted by the cyberattack and resulting claims disruptions with Change Healthcare.

Medicare 43

Medicare CMS Medicaid Article 43

American College of Cardiology

AUGUST 15, 2024

The Centers for Medicare and Medicaid Services (CMS) on Aug. 15 announced the results of price negotiations for the first 10 drugs selected for the Medicare Drug Negotiation Program, made possible by the passage of the Inflation Reduction Act in 2022.

Medicare 41

Medicare CMS Medicaid Article 41

American College of Cardiology

DECEMBER 2, 2024

The Centers for Medicare and Medicaid Services (CMS) released the 2025 Medicare Physician Fee Schedule (PFS) final rule on Nov. Of note, the 2025 PFS conversion factor is $32.3465, a reduction of 2.83% from $33.2875 in 2024.

Medicare 41

Medicare CMS Medicaid Article 41

Cassling

JANUARY 10, 2023

UPDATE: The penalty phase of the Centers for Medicare & Medicaid Appropriate Use Criteria (AUC) program has been suspended until further notice. A major goal of the AUC is to help providers order the most appropriate test for their patients by using a Clinical Decision Support Mechanism (CDSM).

Medicaid 52

Medicaid Medicare CMS Blog 52

American College of Cardiology

JANUARY 3, 2025

The Centers for Medicare and Medicaid Services (CMS) created two new G codes in the 2025 Medicare Physician Fee Schedule final rule that will provide reimbursement for atherosclerotic cardiovascular disease (ASCVD) risk assessment and risk management services.

Reimbursement 43

Reimbursement Medicare CMS Medicaid 43

American College of Cardiology

JULY 18, 2024

The Centers for Medicare and Medicaid Services (CMS) released the proposed 2025 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System rule on July 10. CMS proposes a 2.6% increase to OPPS payment rates that reflects a market basket update of 3.0%

Hospital 43

Hospital CMS Medicaid Medicare 43

American College of Cardiology

SEPTEMBER 5, 2024

The ACC submitted formal comments to the Centers for Medicare and Medicaid Services (CMS) on Sept. 4, providing feedback and raising concerns on several issues of relevance to the cardiovascular community in the 2025 Hospital Outpatient Prospective Payment System (OPPS) proposed rule.

Hospital 43

Hospital CMS Medicaid Medicare 43

American College of Cardiology

JANUARY 8, 2025

The Centers for Medicare and Medicaid Services (CMS) has temporarily reassigned coronary CT angiography (CCTA) codes 75572-75574 from ambulatory payment classification (APC) 5571 to APC 5572 in the 2025 Outpatient Prospective Payment System (OPPS) final rule. in 2024 to $357.13 in 2025.

Reimbursement 41

Reimbursement CMS Medicaid Medicare 41

American College of Cardiology

JULY 10, 2024

The Office of the National Coordinator for Health Information Technology (ONC) released on July 10 the Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability (HTI-2) proposed rule, building on the HTI-1 final rule released in 2023 and additional information blocking rules released (..)

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CMS Medicaid Public Health Medicare 41

American College of Cardiology

JANUARY 24, 2024

The final Centers for Medicare and Medicaid Services (CMS) Interoperability and Prior Authorization (PA) Rule released this month marks a major milestone in reforming prior authorization practices and reflects the ongoing work of ACC Advocacy to reduce prior authorization burden on clinicians.

CMS 43

CMS Medicaid Medicare Article 43

American College of Cardiology

NOVEMBER 12, 2024

The Centers for Medicare and Medicaid Services (CMS) released the 2025 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Center (ASC) final rule on Nov. The rule will implement a 2.9% increase to OPPS payment rates that reflects a market basket update of 3.4%

Hospital 40

Hospital CMS Medicaid Medicare 40

American College of Cardiology

JUNE 6, 2024

The ACC submitted formal comments on June 5 to the Centers for Medicare and Medicaid Services (CMS) regarding the Fiscal Year (FY) 2025 Inpatient Prospective Payment System (IPPS) proposed rule.

Reimbursement 41

Reimbursement CMS Medicaid Medicare 41

HeartRhythm

FEBRUARY 23, 2025

1 In the United States, the Centers for Medicare & Medicaid Services (CMS) expanded coverage to include non-MRI-conditional systems ("off-label MRI") under specific conditions. The 2017 Heart Rhythm Society (HRS) expert consensus statement outlined protocols for scanning both MRI-conditional and non-MRI-conditional CIED systems.1

Heart Rhythm 40

Heart Rhythm CMS Medicaid Medicare 40

DAIC

JULY 25, 2024

The CardiAMP clinical development for heart failure is supported by the Maryland Stem Cell Research Fund and is reimbursed by Center for Medicare and Medicaid Services (CMS) for both treatment and control procedures. CAUTION - Limited by United States law to investigational use.

Heart Failure 111

Heart Failure Quality of Life CMS Reimbursement 111

DAIC

MARCH 7, 2024

The CardiAMP HF trial is supported by the Maryland Stem Cell Research Fund and has reimbursement from the Centers for Medicare and Medicaid Services (CMS) for both treatment and control procedures. The CardiAMP HF II trial is expected to similarly secure CMS reimbursement.

Heart Failure 105

Heart Failure Biomarkers Reimbursement CMS 105

DAIC

MAY 2, 2024

The CardiAMP cell therapy trials for the indications of both chronic myocardial ischemia and ischemic heart failure are covered by the Center for Medicare and Medicaid for both treatment and control procedures. CAUTION - Limited by United States law to investigational use.

Ischemia 95

Ischemia Angina Heart Failure Outcomes 95

Stroke Journal

JANUARY 30, 2025

This initiative aimed to enhance the post-discharge process to improve care quality and reduce missed follow-ups.Methods:We implemented a streamlined follow-up process for stroke patients discharged home, aligning with the Centers for Medicaid and Medicare (CMS) definition of the Transitional Care Management (TCM).

CMS 40

CMS Stroke Strokes Reimbursement 40

Stroke Journal

JANUARY 30, 2025

This initiative, led by Advanced Practice Providers (APPs), aimed to refine the post-discharge process to enhance care quality and reduce missed follow-ups.Methods:We introduced a streamlined follow-up process for stroke patients discharged home, adhering to the Centers for Medicaid and Medicare (CMS) Transitional Care Management (TCM) model.

CMS 40

CMS Stroke Strokes Reimbursement 40

DAIC

JUNE 4, 2024

Even when social determinants of health (SDOH) are screened, they do not guide the development of actionable clinical care plans that are meaningful to the patient for their health management or recovery. This missing puzzle piece matters now more than ever.

Stroke 115

Stroke Strokes Innovation Research 115

American College of Cardiology

FEBRUARY 1, 2025

Initiatives such as the World Health Organization's "Medication Without Harm" and the Centers for Medicare and Medicaid Services' (CMS) expanded quality measures aim to reduce preventable emergency visits and hospital admissions due to medication-related harm.

Cardiovascular Disease 40

Cardiovascular Disease Coronary Artery Disease CMS Hospital 40

Stroke Journal

JANUARY 30, 2025

We longitudinally followed the patients by linking the registry data to the Center for Medicare&Medicaid Service (CMS) claims data.

Medicare 40

Medicare CMS Medicaid Myocardial Infarction 40

DAIC

MARCH 5, 2024

Andrea Fletcher , Chief Digital Strategy Officer and Director of the Digital Service at Centers for Medicare and Medicaid Services ( CMS ) will present, “ Teaching the Elephant to Dance: Digital Transformation in the United States ” on March 13 in an afternoon education session.

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CMS COVID-19 Medicare Education 52

DAIC

MARCH 3, 2025

GE HealthCare will mark the commercial launch of Flyrcado at the annual American College of Cardiology congress in Chicago from March 29-31, 2025, and expects to receive pass-through status from the US Centers for Medicaid and Medicare (CMS) shortly thereafter, enabling separate reimbursement for Flyrcado in the hospital outpatient setting.

Coronary Artery Disease 52

Coronary Artery Disease Ischemia Exercise Hospital 52

DAIC

MARCH 7, 2024

Data was pulled from 2010–2019 Physician/Supplier Procedure Summary (PSPS) files obtained from the Centers for Medicare and Medicaid Services (CMS) website. Rao, MD, FACR, from Thomas Jefferson University Hospitals.

Technology 111

Technology Document Cardiovascular Imaging Cancer 111

GEMMS

MARCH 7, 2024

In late 2023, CMS released the 2024 Medicare Physician Fee Schedule (MPFS) Final Rule, ushering in key policy changes for the Quality Payment Program (QPP). The 2024 payment adjustment is important to compensation for Medicaid services provided. Be sure to check your qualifying status using the QPP Participation Status Tool.

Medicare 52

Medicare CMS Document Technology 52

Society of Thoracic Surgeons - Technology

OCTOBER 21, 2021

The linkage also would allow registries to continue providing critical information for approval and coverage of innovative medical interventions and preserve the government’s authority to authorize Medicare Coverage with Evidence Development (CED).

Technology 40

Technology Coronary Artery Bypass Graft Cardiothoracic Aortic valve 40

DAIC

MARCH 14, 2024

Ensure all Medicare Administrative Contractors (MACs) and health plans are accepting paper claims. AMA is hearing reports that despite CMS instructions, some MACs are still requiring a waiver to accept paper claims. CMS should ensure that MACs allow paper claims without waivers.

CMS 101

CMS Medicare Medicaid Technology 101

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Study Population includes all patients with an ischemic stroke inpatient admission in 2018 and were continuously enrolled with Medicare FFS for 1 year prior to and following their initial 2018 stroke admission. Stroke: Vascular and Interventional Neurology, Volume 3, Issue S2 , November 1, 2023.

Risk Factors 40

Risk Factors Stroke Strokes Medicare 40