CMS Maintains Coverage of CCTA

On March 12, the Centers for Medicare & Medicaid Services (CMS) announced that no national coverage determination (NCD) is appropriate for cardiac CT angiography (CCTA) to diagnose coronary artery disease (CAD)-and thus, Medicare reimbursement remains intact. In a final decision memo that was issued a day earlier than expected, CMS maintained the status quo that coverage should be determined by local contractors through the local coverage determination process or case-by-case adjudication.

When CMS first proposed the coverage decision in December 2007, the agency proposed to withdraw all local coverage (coverage for CCTA exists in all 50 states) and initiate a national coverage decision, which would have required the initiation of a clinical trial to establish whether CCTA is useful for patients with two narrow indications: symptomatic patients with chronic stable angina at intermediate risk of CAD, or symptomatic patients with unstable angina at a low risk of short-term death and intermediate risk of CAD. Critically, no detail was provided as to how that clinical trial would be constructed, leaving the CCTA market in flux.

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