HeartFlow Announces New Reimbursement Code and Increased Payment for FFR_CT

Category I CPT code for Fractional Flow Reserve derived from Computed Tomography will provide broader access to HeartFlow’s AI-powered technology, a standard of care for evaluating and treating coronary artery disease

MOUNTAIN VIEW, Calif. – January 23, 2024 — HeartFlow, Inc., a leader in non-invasive integrated artificial intelligence (AI) heart care solutions, announced FFR_CT was transitioned to a Category I Current Procedural Terminology (CPT^®) code beginning January 1, 2024.

The new code, designated by The American Medical Association (AMA), supports FFR_CT as the standard of care in assessing patients with suspected coronary artery disease (CAD). In the hospital setting, CMS increased payment for the FFR_CT service by ~7% for 2024. The new code can be used for hospital outpatient, physician offices, or imaging centers. As part of converting to a Category I code, relative value units (RVUs) have been assigned to FFR_CT , which provides payment to physicians for the service.

In response to increased utilization of the HeartFlow FFR_CT Analysis service, strong evidence for its clinical value and inclusion in updated practice guidelines, the American College of Cardiology (ACC), American College of Radiology (ACR), and the Society of Cardiovascular Computed Tomography (SCCT) petitioned the AMA for the Category I CPT code, which will replace four existing Category III CPT codes. In addition, the AMA released guidance for appropriate use of the new FFR_CT code in the CPT^® Changes 2024: An Insider’s Viewbook which describes the covered service as allowing the physician to¹:

• Examine and query the entire model and capture noninvasive estimated coronary FFR values anywhere within the coronary tree
• Evaluate multiple and sequential lesions
• Determine the location of the disease burden and the lesion with most hemodynamic significance allowing for a targeted interventional approach

HeartFlow’s FFR_CT Analysis meets the AMA Guidance for the Category 1 code to allow physicians to enable patient care compliantly.

“We appreciate the American Medical Association’s decision to assign FFR_CT a Category I CPT code, a decision backed by years of research that highlights the positive impact FFR_CT can have on the diagnosis and eventually treatment of patients with coronary artery disease,” said John Farquhar, CEO of HeartFlow. “This recognition emphasizes the value and importance of FFR_CT Analysis to help clinicians accurately diagnose CAD in patients. Better reimbursement for hospitals leads to improved accessibility to this technology, which is a win for everyone involved, most notably patients.”

HeartFlow remains dedicated to reshaping cardiovascular care and ensuring that hospitals have access to comprehensive, accurate, and efficient solutions in precision coronary care. HeartFlow’s suite of non-invasive technologies helps clinicians identify stenoses in the coronary arteries (RoadMap™ Analysis), assess coronary blood flow (FFR_CT Analysis), and characterize and quantify coronary atherosclerosis (Plaque Analysis).

About HeartFlow

HeartFlow is transforming precision coronary care with the only AI-powered non-invasive integrated heart care solution across the CCTA pathway. As the pioneer of FFR_CT, which is now supported by the ACC/AHA Chest Pain Guidelines, HeartFlow continues to advance the diagnosis and management of CAD. HeartFlow’s suite of non-invasive technologies includes its FFR_CT Analysis, RoadMap™Analysis, and Plaque Analysis. To date, more than 500 peer-reviewed publications have validated our approach and, more importantly, our technologies have helped clinicians diagnose and manage over 250,000 patients. For more information, visit www.heartflow.com and connect on Twitter and LinkedIn.

Contact

Linly Ku
HeartFlow
media@heartflow.com

¹ From AMA CPT Changes 2024. CPT Copyright 2022 American Medical Association. All rights reserved. CPT^® is a registered trademark of the American Medical Association.