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CMS Releases 2025 Medicare Physician Fee Schedule and Hospital OPPS Final Rules

American College of Cardiology

The Centers for Medicare and Medicaid Services (CMS) released the 2025 Medicare Physician Fee Schedule (PFS) final rule and the 2025 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Center (ASC) final rule on Nov. Of note, the 2025 PFS conversion factor is $32.3465, a reduction of 2.83% from $33.2875 in 2024.

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HeartFlow AI Plaque Analysis Achieves Major Milestone Towards Medicare Coverage

DAIC

HeartFlow’s accurate and actionable Plaque Analysis aligns with the Centers for Medicare & Medicaid Services (CMS) commitment to supporting technologies that enhance diagnostic accuracy and patient care: HeartFlow Plaque Analysis is the only FDA cleared plaque analysis with a reported 95% agreement prospectively compared to the gold standard, IVUS.¹

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Abstract 4119868: Statin and PCSK9 Inhibitor Utilization and Spending in Medicaid between 2018 to 2022: A National Analysis

Circulation

Introduction:Low-income working-aged adults in the Medicaid program have a high burden of cardiovascular risk factors and disease, but often face barriers accessing necessary therapies. However, Medicaid spending on statins decreased by 7.1%, from $246.2 million statin prescriptions in 2018 compared to 20.3 million to $226.8

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AliveCor's Kardia 12L ECG System Receives Category III CPT Codes

DAIC

CPT codes are widely used by government payers, including Medicare and Medicaid, and commercial insurance companies to identify healthcare services and procedures for reimbursement.

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CMS Releases Proposed 2025 Medicare Physician Fee Schedule and Hospital OPPS Rule

American College of Cardiology

The Centers for Medicare and Medicaid Services (CMS) has released the proposed 2025 Medicare Physician Fee Schedule (PFS). The overall reimbursement for cardiovascular services is projected to remain flat compared with 2024, with changes to policies and individual services roughly balancing out.

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

DAIC

CMS previously published a New Technology APC (Ambulatory Payment Classifications) code that covers the CardiAMP Cell Therapy investigational study procedure, including the BioCardia investigational products utilized to perform the study procedure, allowing the study centers to be reimbursed for the study procedure and products.

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CMS Grants Distinct TPT Device Code and Category to Recor Medical for Ultrasound Renal Denervation

DAIC

Centers for Medicare & Medicaid Services (CMS) have granted the company’s Paradise Ultrasound Renal Denervation system a Transitional Pass-through (TPT) payment. The approval of TPT offers incremental reimbursement payments for outpatient procedures performed with ultrasound renal denervation for Medicare fee-for-service beneficiaries.

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