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 44

Becker's Hospital Review - Cardiology

JANUARY 13, 2025

"CMS proposes Medicare and Medicaid coverage for implantable pulmonary artery pressure sensors to manage heart failure. Final decision to be published on Jan.

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CMS Heart Failure Medicaid Medicare 52

CardiacWire

AUGUST 18, 2024

The White House finally unveiled its negotiated Medicare drug prices , bringing 38%-76% reductions to the first 10 drugs, while drawing mixed industry reactions. Medicare drug price negotiations are one of the highlighted results of 2022’s Inflation Reduction Act, allowing CMS to negotiate drug prices for the very first time.

Medicare 59

Medicare CMS Drug Costs Diabetes 59

American College of Cardiology

APRIL 17, 2025

The Centers for Medicare and Medicaid Services (CMS) released the fiscal year (FY) 2026 Inpatient Prospective Payment System (IPPS) proposed rule on April 11, proposing a net increase of 2.4% for inpatient hospital payments.

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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.

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Becker's Hospital Review - Cardiology

NOVEMBER 25, 2024

reported the highest Medicare payment of $38,459 for heart attack care between July 1, 2020, and June 30, 2023, according to CMS data published Oct. Memorial Hospital at Gulfport (Miss.)

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Heart attacks Heart Attack Medicare Hospital 52

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 44

Medicare CMS Medicaid Article 44

DAIC

MARCH 27, 2025

This launch coincides with the receipt of pass-through status by the CMS, effectiveApril 1, securing a drug-specific Healthcare Common Procedure Coding System (HCPCS) billing code and coverage for traditional Medicare beneficiaries.

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Coronary Artery Disease CMS Innovation Ischemia 52

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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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.

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Medicare CMS Medicaid Article 44

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

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.

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Medicare CMS Medicaid Article 42

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."

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Strokes Stroke Outcomes Quality of Life 52

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 42

Medicare CMS Medicaid Article 42

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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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.

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Reimbursement Medicare CMS Medicaid 44

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%

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Hospital CMS Medicaid Medicare 44

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).

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Medicaid Medicare CMS Blog 52

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.

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Hospital CMS Medicaid Medicare 44

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.

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Reimbursement CMS Medicaid Medicare 42

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.

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CMS Medicaid Medicare Article 44

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 42

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% reduced by a productivity adjustment of 0.5%.

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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.

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Reimbursement CMS Medicaid Medicare 42

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

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Heart Rhythm CMS Medicaid Medicare 40

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).

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CMS Strokes Stroke 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.

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CMS Strokes Stroke Reimbursement 40

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.

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Ischemia Angina Heart Failure Outcomes 95

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.

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Cardiovascular Disease Coronary Artery Disease CMS Hospital 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.

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Strokes Stroke Innovation Research 115

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

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). We calculate cost measures, based on your Medicare claims, to determine the cost of the care you provide to certain patients.

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Medicare CMS Document Technology 52

Stroke Journal

JANUARY 30, 2025

Clinical information on a matched sub-population was linked from the EMR of a 7-hospital certified stroke health system.

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Inpatient Strokes Stroke CMS 40

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).

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Technology Coronary Artery Bypass Graft Cardiothoracic Aortic valve 40

DAIC

MARCH 13, 2024

CMS has reviewed the CardiAMP Heart Failure II Trial and approved the investigational product, related and routine items and services for purposes of Medicare coverage. We are pleased that CMS has provided coverage support for the confirmatory CardiAMP Heart Failure II study.” said Peter Altman , PhD.,

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CMS Heart Failure Reimbursement Quality of Life 111

DAIC

MARCH 28, 2025

vii Similarly, recent increases in Medicare reimbursement rates for CCTA are a positive step towards making this technology more accessible. a huge win: CMS significantly increases Medicare payments for cardiac CT. 2012) 380:2095128. 10.1016/S0140-6736(12)61728-0. link] iv IMV.2023 2023 CTMarket Outlook Report (p. v Walter, M.

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Technology Coronary Artery Disease Atrial Fibrillation Medicare 59

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.

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CMS Medicare Medicaid Technology 101