CMS publishes final Clinical APC rule for Ultromics EchoGo® Heart Failure

From January 1st 2024, clinicians can now reimburse for EchoGo® Heart Failure using APC 5743 with a payment rate of $284.88.

Ultromics, a leading health technology company at the forefront of detection of heart failure and its phenotypes, announces a significant development regarding the reimbursement code for its flagship product, EchoGo® Heart Failure. The Centers for Medicare & Medicaid Services (CMS) has updated the assignment of the clinical ambulatory payment classification (APC) for Healthcare Common Procedure Coding System (HCPCS) code C9786, resulting in it being assigned to APC 5743 with a payment rate of $284.88 effective January 1, 2024.

The revised Medicare payment to hospital outpatient departments for the service will provide better support for healthcare facilities utilizing this ground-breaking technology and should facilitate broader access for patients across hospital outpatient settings. This follows the already published approval of a new CMS technology add-on payment (NTAP) for reimbursement in the hospital inpatient setting effective October 1^st 2023.

EchoGo® Heart Failure, an AI-powered device that analyzes minimally invasive echocardiogram scans, incorporates an AI decision support algorithm for HFpEF detection. This technology automates the detection process for a complex clinical syndrome where diagnosis is often uncertain, leading to more accurate and timely diagnoses potentially enabling earlier disease detection and expediting treatment.

"Dr. Ross Upton, CEO and Founder of Ultromics, emphasized, "This milestone significantly empowers hospitals to accelerate the integration of EchoGo® Heart Failure into their workflow, ultimately improving HFpEF detection within their healthcare systems. Given the prevalence of HFpEF, this development marks a crucial step toward identifying and treating this underdiagnosed condition."

The HCPCS code C9786 and new clinical APC assignment signals Ultromics' continued commitment to revolutionizing cardiovascular care and solidifies its position as a leader in the field.

EchoGo® Heart Failure received FDA clearance in the USA in December 2022 and is readily available to healthcare providers across the United States.

For more information about EchoGo® Heart Failure and to learn about how it can benefit your practice, please visit our homepage.

Healthcare providers interested in incorporating EchoGo® Heart Failure into their practice can express their interest here.

For comprehensive information, including the code's official long descriptor and status indicator, please see the OPPS / ASC final rule here.