Elucid Applauds CMS Inclusion of Coronary CTA with Plaque Analysis in 2026 Proposed Medicare Physician Fee Schedule
'Elucid is encouraged by the addition of the Category I CPT code and payment level for coronary CTA with plaque analysis in the Calendar Year 2026 Medicare Physician Fee Schedule proposed rule,' said Elucid CEO Kelly Huang, PhD.
Cardiovascular disease continues to be a critical public health issue in the United States, remaining the leading cause of death nationwide. In 2022, heart disease claimed over 700,000 lives—nearly 1 in every 5 deaths—underscoring the urgent need for early detection and intervention. 1 Despite advances, many high‑risk patients remain undiagnosed until they experience serious cardiac events. The proposed rule by CMS marks a significant step toward broader access to innovative, evidence-based imaging tools that help identify high-risk cardiovascular patients earlier and more accurately.
'Elucid is encouraged by the addition of the Category I CPT code and payment level for coronary CTA with plaque analysis in the Calendar Year 2026 Medicare Physician Fee Schedule proposed rule,' said Elucid CEO Kelly Huang, PhD. 'We commend CMS for ensuring that the proposed payment level reflects the clinical value, technological investment, and expertise needed to perform this service, enabling Medicare beneficiaries to access this technology.'
Coronary computed tomography angiography (CTA) with plaque analysis offers invaluable insights into plaque burden, composition, and morphology, enabling earlier and more accurate identification of high-risk patients who may benefit from targeted medical therapy and lifestyle interventions. Numerous studies have demonstrated that such non-invasive imaging enhances risk stratification and clinical decision-making while reducing the need for more invasive and costly diagnostic procedures.
'Elucid remains optimistic as we await the final publication of the code and payment, effective January 1, 2026,' said Huang. 'We recognize the efforts of societies and physician organizations collaborating with the AMA and CMS to reach an appropriate payment level. We look forward to continued cooperation to enhance patient outcomes and access.'
The proposed rule outlines payment policies and rates for services furnished under Medicare Part B. The inclusion of coronary CTA with plaque analysis represents a significant advancement for precision cardiovascular care. It follows a new CMS rule that went into effect January 1, 2025, which doubled the amount paid to hospitals and outpatient clinics who perform cardiac CT scans from $175 to $357. This has already allowed more hospitals, particularly those in non-urban areas, to be able to offer this service, reducing disparities in care.
About Elucid
Elucid is a Boston-based AI medical technology company dedicated to developing technology designed to provide physicians with a more precise view of atherosclerosis (coronary plaque buildup), the root cause of cardiovascular disease. The company's PlaqueIQ TM image analysis software is designed to help physicians prioritize and personalize treatment based on actual disease, rather than population-based risk of disease. PlaqueIQ includes the only FDA-cleared computed tomography angiography (CTA) algorithm that objectively quantifies plaque morphology validated against ground truth histology, the gold standard for characterization of plaque, as indicated by renowned pathologists. PlaqueIQ equips physicians with critical information regarding the type and amount of plaque in arteries that can lead to heart attack and stroke. Elucid is also pursuing an indication for FFR CT, derived from its plaque algorithm, to help identify coronary blockages and the extent of ischemia non-invasively. For more information, visit elucid.com.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Business Wire
20 minutes ago
- Business Wire
NextGen Healthcare Chosen by Phoenix Heart to Optimize Financial Outcomes and Enhance Patient Experience
REMOTE-FIRST COMPANY/PHOENIX--(BUSINESS WIRE)--NextGen Healthcare, a leading provider of innovative, cloud-based healthcare technology solutions, has been selected by Phoenix Heart to improve workflows, deliver meaningful financial and operational analytics, and enable a better experience for patients, providers and staff. The NextGen Cardiology Suite, a specialty package that overlays the NextGen® Enterprise EHR (electronic health record), will reduce friction by supporting specialty-specific workflows. 'NextGen Healthcare understands our needs and shares our commitment to making healthcare as seamless as possible for providers, staff, and the communities we serve,' said Elizabeth Saylor, chief executive officer, Phoenix Heart Share Voted the state's #1 cardiology group for eight consecutive years in the annual The Best in Arizona Business poll, Phoenix Heart offers heart, vein, and vascular care across eight locations in the greater Phoenix region. Until now, staff at Phoenix Heart have relied on tedious manual processes to complete mission-critical workflows. NextGen® Enterprise PM (practice management), NextGen® Financial Analytics and NextGen® Operational Analytics will be integrated to simplify workflows while offering transparency, predictive analytics, and actionable insights. 'NextGen Healthcare understands our needs and shares our commitment to making healthcare as seamless as possible for providers, staff, and the communities we serve,' said Elizabeth Saylor, chief executive officer, Phoenix Heart. 'We're excited to work together to improve clinical, operational, and financial processes and continue raising the bar in cardiovascular care.' NextGen® Patient Engage powered by Luma will boost staff efficiency by equipping patients to complete pre-visit intake at their own convenience from their personal devices. The Instant Medical History enhancement will capture discrete data from patients during remote check-in and seamlessly deliver that information to the appropriate places in the system. NextGen® Automated Document Sharing will also automate outbound faxes and expedite the delivery of documents into patient portals—minimizing work for staff and making it easier for patients to quickly access information. 'Phoenix Heart has been leading the way in cardiovascular care in Arizona for over four decades,' said Srinivas (Sri) Velamoor, president and chief operating officer, NextGen Healthcare. 'We are privileged to support Phoenix Heart with the next stage of their growth journey and elevate the provider, staff, and patient experiences with specialty-specific solutions that reduce burdens and make healthcare delivery more intuitive.' To learn more about how NextGen Healthcare helps cardiology practices achieve their goals, visit About Phoenix Heart Voted No. 1 in cardiology groups by Ranking Arizona magazine's Best in AZ Businesses readers' poll, Phoenix Heart is the leading cardiology group in the greater Phoenix area. Phoenix Heart has eight offices, conveniently located in Glendale, Scottsdale, Avondale, Anthem, Black Canyon City, Buckeye, Cottonwood, and Laveen Village. Since its inception in 1981, Phoenix Heart has set the gold standard for cardiological care in Arizona and beyond. The cardiologists that make up the medical team at Phoenix Heart represent an incredibly diverse and elite background of training, skills, and specialties. They're committed to improving and enriching the lives and health of every patient they see and are consistently at the forefront of adopting the newest and best technologies to advance the health of their patients. About NextGen Healthcare NextGen Healthcare, Inc. is a leading provider of innovative healthcare technology and data solutions. We are reimagining ambulatory healthcare with award-winning EHR, practice management and surround solutions that enable providers to deliver whole-person health and value-based care. Our highly integrated, intelligent, and interoperable solutions increase clinical quality and productivity, enrich the patient experience and drive superior financial performance. We are on a relentless quest to achieve better healthcare outcomes for all. Learn more at and follow us on Facebook, X, LinkedIn, YouTube, and Instagram.
Business Wire
20 minutes ago
- Business Wire
Nalu Medical Achieves National Payer Milestone with Aetna Coverage for PNS Therapy
CARLSBAD, Calif.--(BUSINESS WIRE)--Nalu Medical, Inc., a leader in miniaturized neuromodulation therapies, is pleased to announce that Aetna Inc. has issued an updated medical policy designating the Nalu Neurostimulation System as medically necessary for the treatment of chronic pain of peripheral nerve origin. This change, effective July 31, 2025, marks a critical milestone in Nalu's mission to expand access to safe, innovative, drug-free alternatives for chronic pain relief. This policy shift moves Nalu from its prior classification of 'Investigational/Experimental' to 'Medically Necessary' for eligible patients—opening access to more than 22 million additional covered lives across the U.S. 'Aetna's recognition of Nalu as a medically necessary therapy is a powerful validation of our technology, clinical evidence, and commitment to patient outcomes,' said Tom West, Chief Executive Officer of Nalu Medical. 'We've built a robust body of clinical data demonstrating that Nalu PNS provides safe, effective, and durable relief for patients living with chronic, intractable pain, as well as healthcare economic data that demonstrates use of Nalu PNS results in significant cost savings. We're proud to see a leading payer like Aetna acknowledge that value, and we look forward to engaging with other health plans to expand access to this life-changing therapy.' Chronic peripheral nerve pain is often debilitating and unresponsive to conventional therapies, including long-term medication and surgery. The Nalu Neurostimulation System offers a minimally invasive, drug-free alternative that delivers precise electrical stimulation to targeted peripheral nerves, providing long-lasting relief while reducing the risks of opioid dependency and avoiding systemic side effects. About the Nalu Neurostimulation System The Nalu System consists of a fully featured, battery-free, miniaturized implantable pulse generator (IPG) 1 that is powered wirelessly by an externally worn Therapy Disc and controlled through a smartphone-based remote control app. Despite its small size, the Nalu micro-IPG™ delivers treatment capabilities similar to larger IPGs as well as advantages associated with advanced waveforms, extensive programming options, exceptional upgradability, and an expected service life of 18 years. The Nalu Neurostimulation System has been repeatedly recognized for its revolutionary technology, including being named as one of the world's top 100 new products by R&D Magazine in 2021 and ranking number 19 in the 2023 Deloitte Technology Fast 500. It is FDA-cleared for Spinal Cord Stimulation (SCS) and Peripheral Nerve Stimulation (PNS) indications. To learn more, visit About Nalu Medical, Inc. Nalu is a Carlsbad, California-based medical technology company focused on developing and commercializing innovative and minimally invasive solutions for patients with chronic neuropathic pain. The Nalu Neurostimulation System delivers gentle electrical pulses to the nervous system to modulate pain signals before they get to the brain. The Nalu Neurostimulation System was designed to address major unmet needs in the treatment of chronic neuropathic pain and provide a differentiated value proposition for patients and physicians. [1] Data on file, Nalu Medical, Inc. 2025.
UPI
an hour ago
- UPI
Rural health clinics, services at risk with $1 trillion Medicaid cuts
1 of 2 | President Donald Trump shows his signature after signing a new tax and immigration bill during a ceremony at the White House in Washington, D.C. on July 4. The bill cuts nearing $1 trillion from Medicaid. Photo by Kent Nishimura/UPI | License Photo July 16 (UPI) -- The dust has settled on Capitol Hill over the passage of President Donald Trump's legislative agenda bill but healthcare experts continue to prepare for the fallout of more than $1 trillion in Medicaid cuts. The legislative agenda bill is projected to cut more than $1 trillion in Medicaid spending by the federal government over the course of a decade. The cuts stem from greater eligibility requirements such as work requirements and limits on state-imposed Medicaid provider taxes. The Congressional Budget Office estimates that the number of people who are uninsured in the United States will increase by 7.8 million as a result of Medicaid cuts. The loss of Medicaid coverage for patients also means a loss of potential revenue for care providers. The effects will be felt acutely in rural areas, according to studies by the American Hospital Association. Rural hospitals are projected to experience a $50.4 billion reduction in federal Medicaid dollars in the next 10 years. Sarah Hohman, director of government affairs for the National Association of Rural Health Clinics, told UPI that many rural facilities already struggle "on a good day." A mixture of Medicare and Medicaid patients is what helps them stay open. "Clinics' greater concern, when it comes to these reforms, is if the coverage losses pan out as they are estimated, that would mean that they are treating fewer patients that are covered by insurance," Hohman said. "The more you have uncompensated care and individuals not able to pay, your balance gets concerning pretty quickly. That really threatens the financial viability in these areas." An estimated 16.1 million people living in rural communities have Medicaid coverage, according to the American Hospital Association. In sparsely populated states like Montana, Wyoming and Alaska, more than 50% of Medicaid recipients live in rural areas. The association estimates that the reductions in Medicaid spending outlined by the legislative agenda bill will result in thousands of lost jobs and millions in lost revenue. Republican-led states stand to lose the most. Estimates are based on Medicaid spending data from the Medicaid and CHIP Payment Access Commission, a government commission that advises Congress on Medicaid related issues and policies. Wyoming, the least-populated state, is estimated to lose 13,772 jobs over the next decade for every $1 billion lost in Medicaid funding. The state has a population of 587,618 and the job loss would equate to about 2.8% of the population, according to the U.S. Census Bureau. The loss of jobs is projected to cost the state $1.4 billion in economic activity and about $33.5 million in tax revenues. Texas is projected lose the most jobs at 18,178, followed by Louisiana which is slated to lose 16,787 jobs. A loss of revenue and loss of skilled workers creates conditions for closures. "Typically you start to see closures of certain services," Hohman said. "OB[-GYN] closes. That's a very common first kind of service line to go. You might see some other specialty services close, particularly that have really low volumes. Then they try as hard as they can to keep the core emergency services and some beds." For clinics, there are not as many services that can be sacrificed while keeping facilities open. "On the outpatient side that I represent, it can be harder to chip away at it because they don't necessarily have as many service lines as a hospital," Hohman said. "They have to make very tough decisions about whether their facility can continue to exist in those communities." There are about 5,600 rural health clinics located in 47 states. They serve as the main source of outpatient healthcare in their communities, according to Hohman. The legislative agenda bill includes funding for a $50 billion Rural Health Transformation Program. Funding is allotted to $10 billion each fiscal year beginning in 2026 and ending in 2030. The Rural Health Transformation funds are to be awarded to states that apply for the funding to be used. Applications are to include a rural health transformation plan, detailing how the state intends to use those funds. Some permitted uses of funds include improving access to hospitals and other care providers for rural residents, investing in new technology and improving the health care outcomes for rural patients. Hohman and other rural healthcare advocates have called for a program like this for some time, she said, but the language of the bill remains vague. It leaves room for states to interpret what improving healthcare means. "It's more than anything a safety net healthcare fund," Hohman said. "We have a lot of concerns about what that's ultimately going to look like. There's really no requirement that these monies go to facilities directly. They can be used broadly at the state level to help transform their healthcare. It is a little bit of a cushion in the GOP minds but we will kind of believe it more as we see it." Maggie Elehwany, senior vice president of public policy for Argentum, a national trade association serving senior living communities, told UPI she is pleased with one provision that was removed from the bill. Elehwany is the former vice president of government affairs for the National Rural Health Association. A previous version of the bill included cuts to the federal and state matching program, a program that sees the federal government match state spending on Medicaid. "We are pleased to report that we were able to prevent those cuts and other associations certainly lobbied as well," Elehwany said. "That's responsible for our state payments. But we know that states are going to have overall less Medicaid dollars. That could have an indirect impact on seniors and those folks in our communities." The United States is an aging population facing shortages in skilled nursing and facilities for senior care and living. In 2030, for the first time, the U.S. population will include more seniors than children, according to the American Association of Retired Persons. About two-thirds of seniors need some form of long-term care, Elehwany said. "We're not prepared for the housing needs, for the care providing needs, financially we don't have enough people saving for their retirement, let alone for their long-term healthcare needs," she said. To make up for shortages, Elehwany and other senior care advocates called on lawmakers to create a tax credit for individuals who help care for seniors, such as people who provide care to loved ones. It was one provision that they were not successful in getting into the bill. "But we are pleased they adjusted the $6,000 deduction for Social Security," she said. "They means adjusted a tax refund for seniors with limited income so that they would get a significant amount of dollars back. So that's an important provision in there."
