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CMS Seeks Feedback on Cardiac CT Billing and Payment

American College of Cardiology

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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BioCardia Announces CMS Approval of Coverage for CardiAMP Cell Therapy Confirmatory Phase III Heart Failure Study

DAIC

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. 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.

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Highlights From the Proposed 2025 Hospital OPPS Rule

American College of Cardiology

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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ACC Submits Comments on 2025 Hospital OPPS Proposed Rule

American College of Cardiology

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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HeartFlow Announces New Reimbursement Code and Increased Payment for FFRCT

DAIC

In the hospital setting, CMS increased payment for the FFRCT service by ~7% for 2024. The new code can be used for hospital outpatient, physician offices, or imaging centers. As part of converting to a Category I code, relative value units (RVUs) have been assigned to FFRCT, which provides payment to physicians for the service.

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Private Equity’s Cardiovascular Expansion

CardiacWire

The transition to outpatient and value-based care suggests that more of that money could flow to practices with the right strategies and capabilities. Practices with Ambulatory Surgery Centers (ASCs) are becoming particularly attractive, as CMS added 23 ASC cardiac catheterization and PCI codes in just the last two years.

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The Evolving Computed Tomography Market

DAIC

It reported the rate of CCTA exams by radiologists in hospital outpatient departments increased markedly from 2010 to 2019. Over that period, the rates of CCTA by radiologists in hospital outpatient departments increased by 355%, according to findings of Russell A. Reeves, MD, Ethan J. Halpern, MD, and Vijay M.