Prevencio this week announced that the Centers for Medicare & Medicaid Services (CMS) has set a national Medicare payment rate of $390.75 for three artificial intelligence (AI)-enabled cardiac blood tests.
The payment rates went into effect January 1 with the Current Procedural Terminology (CPT) billing codes 0308U (for Hart Cadhs), 0309U (for Hart Cve), and 0310U (for Hart Kd).
Hart Cadhs determines whether an adult patient has obstruction of the heart arteries and is at imminent risk of a heart attack, while Hart Cve improves identification for a patient’s short-to-intermediate risk of heart attack, stroke, or cardiac death. Hart Kd is used to diagnose whether a child has Kawasaki disease.
“The Medicare-determined price is additional evidence of the value of Hart testing and is an important step in our commercial strategy to establish the Hart reimbursement framework,” Rhonda Rhyne, president and CEO of Prevenico, said in a statement. “Building on Medicare’s pricing determination, we will work with commercial, self-insured, and governmental insurance programs, including Medicare and Medicaid, to provide patients with broader access to these important cardiac tests.”