A New Era for Cardiovascular Imaging? Implications of the Revoked National Coverage Decision for CT Angiography on Future Imaging Reimbursement

ON DECEMBER 1 3, 2 0 0 7, THE CENTERS FOR MEDICARE AND MEDICAID SRVICES (CMS) issued a proposed national coverage decision (NCD) memorandum for cardiac computed tomographic angiography (CTA) for the diagnosis of coronary artery disease (CAD) that would have drastically reduced coverage for Medicare beneficiaries for CTA. Under this proposal, Medicare coverage for CTA would have been provided only in a small minority of patients and only in the setting of enrollment in an approved research protocol. In its final ruling, released March 12, 2008, CMS reversed its decision and retained the existing coverage policy that gives local Medicare contractors the discretion to reimburse according to their own policy and without a requirement for research participation. Thus CTA will remain reimbursed by Medicare in all 50 states, with the majority of local contractors having similar policies.