What's Happening?
Cigna has announced that it will begin covering Cleerly LABS Advanced Plaque Analysis, an AI-based cardiovascular imaging technology, starting October 1, 2025. This decision makes Cigna the latest major insurer to recognize the clinical and economic value of AI-enabled CT-based Quantitative Coronary Tomography (AI-QCT) and Coronary Plaque Analysis (AI-CPA) technology for cardiovascular care. With over 16 million covered lives, Cigna joins UnitedHealthcare and EviCore in providing Cleerly’s advanced imaging technology. Combined with Medicare’s 2024 coverage decision and an upcoming CPT I code in January 2026, AI-QCT/AI-CPA technology is now covered for over 61 million Americans.
Why It's Important?
Cigna's decision to cover Cleerly's AI-based cardiovascular imaging technology represents a significant advancement in precision medicine for cardiology. The widespread adoption of AI-QCT/AI-CPA technology by major insurers highlights the growing recognition of its clinical benefits, including enhanced insights and more informed care decisions for patients. This coverage expansion could lead to improved cardiovascular care outcomes, particularly for patients with acute or stable chest pain and no known coronary artery disease. By supporting advanced plaque analysis, insurers are facilitating access to cutting-edge diagnostic tools that can aid in early detection and treatment of cardiovascular conditions.
What's Next?
Starting October 1, 2025, all Cigna health plans will cover AI-QCT/AI-CPA imaging for patients who meet specific clinical criteria. This includes patients with acute or stable chest pain, classified as intermediate risk, or CAD-RADS 1, 2, or 3 category, and those with negative or inconclusive cardiac evaluations for acute coronary syndrome. The coverage decision aligns with Medicare’s 2024 coverage and the upcoming CPT I code in January 2026, further solidifying the technology's role in cardiovascular care. As more insurers adopt AI-based imaging technologies, the healthcare industry may see a shift towards more personalized and precise treatment strategies.
Beyond the Headlines
The integration of AI-based imaging technologies into cardiovascular care could have broader implications for the healthcare industry. By enhancing diagnostic accuracy and supporting more informed care decisions, these technologies may contribute to improved patient outcomes and reduced healthcare costs. Additionally, the widespread adoption of AI-QCT/AI-CPA technology by insurers reflects a growing trend towards embracing innovative solutions in healthcare, potentially paving the way for further advancements in precision medicine and AI-driven diagnostics.
