CMS increases reimbursement for AI echocardiography

Ultromics noted that the Centers for Medicare and Medicaid Services (CMS) has effectively raised the reimbursement rate covering its EchoGo Heart Failure software.

CMS updated the assignment of the clinical ambulatory payment classification (APC) for Healthcare Common Procedure Coding System (HCPCS) code C9786, resulting in it being assigned to APC 5743 with a new payment rate of $284. This is an increase from previous reimbursements of $99.81, with the new rate effective January 1, 2024, Ultromics said.

HCPCS code C9786 covers “echocardiography image postprocessing for computer-aided detection of heart failure with preserved ejection fraction, including interpretation and report.”

EchoGo Heart Failure analyzes minimally invasive echocardiogram scans and uses an AI decision support algorithm to detect heart failure with preserved ejection fraction (HFpEF). The technology automates the detection process for a complex clinical syndrome where diagnosis is often uncertain, leading to more accurate and timely diagnoses, according to the vendor.