CMS confirms broadened Medicare coverage of carotid artery stenting in final decision


The Centers for Medicare & Medicaid Services (CMS) has released its final decision regarding National Coverage Determination (NCD) 20.7 covering carotid artery stenting (CAS), essentially confirming the coverage expansion outlined in a July proposed decision memo.

In a communique to its members today, the Society for Vascular Surgery (SVS) said the final decision contained “few substantive changes from what was proposed in July.”

CMS outlined in the decision memo, dated Oct. 11, that it had found “coverage of percutaneous transluminal angioplasty (PTA) of the carotid artery concurrent with stenting is reasonable and necessary with the placement of a Food and Drug Administration [FDA]-approved carotid stent with an FDA-approved or cleared embolic protection device” for Medicare patients who have symptomatic carotid stenosis ≥50% and asymptomatic carotid stenosis ≥70%.

In the July proposed decision, the federal agency detailed an expansion that would significantly broaden coverage for carotid stenting, expanding Medicare coverage to individuals previously only eligible for coverage in clinical trials, removing the limitation of coverage to only high-surgical-risk individuals, and removing facility standards and approval requirements.

“While this outcome was anticipated, the SVS remains concerned,” the SVS said in its statement to members. “The SVS Executive Board will convene next week to thoroughly discuss and will issue a formal statement soon thereafter.”


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