EviCore Expands Coverage to Include Cardiac Imaging AI Analysis
July 15, 2025
EviCore updates its insurance coverage guidelines to reimburse AI software for analyzing coronary CT angiography (CCTA) images.
Key Details
- EviCore now recommends reimbursement for AI-based CCTA analysis from Cleerly, Heartflow, and Elucid.
- Guidelines apply to acute or stable chest pain patients and those with noted coronary stenoses.
- Policy takes effect October 1, 2024.
- Follows Medicare's recent approval and expanded payment for AI-backed CCTA analyses, now covering over 70% of Medicare patients.
- CMS doubled hospital/outpatient reimbursement for cardiac CT scans to $357.13 as of January 2024.
Why It Matters
Expanded payer coverage accelerates the clinical adoption of AI-powered CCTA, increasing access and incentives for hospitals to implement these advanced tools, which can aid early detection and personalized treatment for cardiac patients.