On Demand: 2026 CVSL Reimbursement Updates for Boston Scientific Technologies-Webinar Slides

Webinar Slides

Pdf Summary

This document summarizes 2026 CMS reimbursement updates affecting Boston Scientific cardiovascular technologies and highlights what leaders, cath labs, and coding teams should prepare for. Across Medicare payment systems, CMS finalized overall updates of ~2.6% for FY2026 IPPS (effective Oct. 1, 2025) and ~2.6% for CY2026 OPPS/ASC (effective Jan. 1, 2026). The Physician Fee Schedule (PFS) update is ~3.3% for non–Qualifying Participants, alongside a major reallocation of indirect practice expense that decreases facility PE RVUs (~7%) and increases non-facility PE RVUs (~4%). CMS also finalized a 3-year phaseout of the Inpatient Only (IPO) list, while making multiple changes to the ASC Covered Procedure List (CPL).<br /><br />Key service-line changes include a major overhaul of lower extremity revascularization (LER): the largest vascular CPT coding change since 2011, creating 46 new CPT codes (37254–37299) and retiring 14 prior codes (37220–37235), organized by four LER territories (iliac, femoral/popliteal, tibial/peroneal, and a new inframalleolar territory). Interventional cardiology updates include new CPT codes for complex stenting (92930) and antegrade/retrograde CTO (92945), multiple APC reassignment/payment shifts, and significant outpatient payment improvements for imaging add-ons (IVUS/FFR scenarios). Drug-coated balloon (DCB) procedures move from APC 5192 to APC 5193, substantially increasing the national average payment; AGENT DCB maintains Transitional Pass-Through (TPT) eligibility through Dec. 31, 2027 and also retains NTAP status for inpatient stays (over two midnights).<br /><br />CRM/diagnostics updates include new and revised RPM CPT codes (99454 revised; 99445 and 99470 added), a labeling update for LUX-Dx supporting post-ablation monitoring, and local PFS technical payment changes for external monitoring services. Electrophysiology/WATCHMAN sections emphasize continued inpatient-only status for LAAC in 2026, expanding ASC coverage for ablation procedures, and the importance of robust medical necessity documentation aligned to NCD criteria and AF guidelines, including considerations for concomitant “FARAWATCH” billing impacts. The document closes with available reimbursement education, patient access, and market access support resources from Boston Scientific.

Keywords

2026 CMS reimbursement updates

Boston Scientific cardiovascular technologies

FY2026 IPPS payment update

CY2026 OPPS/ASC payment update

Physician Fee Schedule practice expense RVU reallocation

Inpatient Only list phaseout

ASC Covered Procedure List changes

lower extremity revascularization new CPT codes 37254-37299

drug-coated balloon APC 5193 and AGENT DCB TPT/NTAP

WATCHMAN LAAC inpatient-only status and ablation ASC coverage