Acarix continues progress on reimbursement for CADScor System in US market
Acarix, a leader in rapid AI and acoustics-based cardiac diagnostics, announces updates on the ongoing reimbursement application process and dialogue with the Centers for Medicare and Medicaid Services (CMS).
A second meeting has been held with CMS to discuss reassignment of APC level for the CADScor System CPT code. The purpose of the meeting was to request that the CADScor System Category III CPT code 0716T be reassigned to Ambulatory Payment Classification (APC) 5722 Level 2 Diagnostic Tests, and that the status indicator be changed to “S” for 2025 for hospital outpatient department services.
The meeting with CMS was held to provide technical information about the CADScor System and reiterate that Level 2 Diagnostic test assignment would better and more accurately reflect the resources required to perform the test and its nature as a diagnostic service. Level 2 Diagnostic Tests APC has a payment rate of $311. The decision on this change request will be made available in early November 2024. If CMS decides to grant the APC 5722 Level 2 Diagnostic Tests APC assignment for CADScor then this payment rate could become effective starting January 2025.
The work to change the CADScor System's APC assignment is happening in parallel with the efforts to transition from a CPT III to a CPT I code. Each initiative targets different aspects of coding and reimbursement, ensuring support in both hospital outpatient settings and physician offices.
