On Demand: Optimize Your CCTA & Heartflow Program for Reimbursement Success in 2026-Webinar Recording

Video Transcription

Video Summary

This MedAxiom webinar, hosted by HeartFlow and led by industry experts, focuses on optimizing reimbursement strategies for Coronary CT Angiography (CCTA) and HeartFlow programs in 2026. It provides an overview of HeartFlow’s advanced AI-driven cardiovascular diagnostic tools, including roadmap analysis, plaque analysis, and FFRCT, emphasizing their clinical utility and coverage status. The session details recent CMS final rules affecting outpatient and physician office payments, highlighting the transition of plaque analysis to a Category 1 CPT code (75577) with established RVUs and removal of prior billing restrictions, facilitating smoother reimbursement. <br /><br />Experts discuss the evolution of coverage, noting that Medicare and major commercial payers like UnitedHealthcare and Humana now provide more aligned and comprehensive coverage for plaque analysis. Practical advice is given for prior authorization processes, including key coding changes, proper use of diagnosis codes, and workflow optimization to reduce denials and improve patient access. Attendees are urged to review revenue codes (favoring cardiology codes) and charge amounts to ensure appropriate reimbursements aligned with CMS cost-basis calculations. The HeartFlow team offers support for payer engagement, peer-to-peer reviews, and partnership with managed care teams to secure or expand coverage. The session concludes with a Q&A addressing coding transitions, documentation best practices, and prior authorization nuances, providing actionable insights for administrative and clinical teams to achieve reimbursement success in 2026.

Keywords

Coronary CT Angiography

HeartFlow

reimbursement strategies

CMS final rules

plaque analysis

Category 1 CPT code 75577

prior authorization

Medicare coverage

cardiovascular diagnostics