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CMS Is Taking Another Look At Its TAVR Coverage Rules

 
• By Reed Miller

The US Medicare agency opened a national coverage determination for transcatheter aortic valve replacement at the request of three California physicians who argue that the current limitations on which centers can perform TAVR unnecessarily prevent lower-volume hospitals from providing the procedure as a less invasive option to open surgery.

Core Valve In Situ
Medtronic's CoreValve Transcatheter Aortic Valve Replacement • Source: Medtronic

The US Centers for Medicare & Medicaid Services opened a Medicare national coverage analysis for transcatheter aortic valve replacement in response to a request from physicians who believe the procedural volume requirements for heart teams and hospitals in the current coverage policy are too restrictive.

The current national coverage determination policy for TAVR (NCD 20.32) has been in place since 2012. It is a coverage-with-evidence-development (CED) policy that provides Medicare coverage for TAVR procedures to...

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