CMS Increases payments for CCTA Services from 2025

The Centers for Medicare and Medicaid Services (CMS) has implemented a significant update to Medicare reimbursement for coronary computed tomography angiography (CCTA) exams, effectively doubling the payment rate from $175 to $357.13. This change, included in the 2025 Hospital Outpatient Prospective Payment System (HOPPS) final rule, reclassifies CCTA into a higher ambulatory payment classification (APC) that better reflects the costs associated with these essential cardiac services. 

The reclassification is expected to enhance patient access to CCTA across the United States, aligning Medicare reimbursement more appropriately with the value CCTA provides in cardiac care. Medical societies, including the Society of Cardiovascular Computed Tomography (SCCT) and the American College of Cardiology (ACC), have expressed approval, viewing this ruling as a significant victory for healthcare providers and the cardiac imaging community, ultimately improving patient access to vital diagnostic tools.

Historically, hospitals faced billing limitations for CCTA under lower-paying revenue codes. Revenue codes for CCTA—specifically 75572, 75573, and 75574—are now assigned to APC 5572, allowing hospitals to receive more appropriate compensation. Under the new policy, hospitals can now use the cardiology revenue code (0480) for CCTA services, alleviating financial pressures on medical practices and expanding the availability of cardiac CT testing across more facilities. This positive change results from advocacy efforts by various medical organizations over the past six years.

In addition to increased CCTA reimbursement, CMS has raised payments for related services. The global payment for CCTA under the Physician Fee Schedule is now $318, and payments for advanced AI analyses related to plaque assessments will be set at $950. These updates are expected to encourage broader adoption of CCTA and associated technologies in diagnosing and managing coronary artery disease (CAD).