What's Happening?
Heartflow has achieved nationwide coverage from Aetna for its AI-driven Plaque Analysis, marking a significant shift in the standard of care for coronary artery disease. This coverage, effective December
23, 2025, is supported by a new Category I CPT code, providing a clear reimbursement pathway. The technology, which quantifies plaque in coronary arteries, is now considered a standard rather than experimental, with the potential to significantly impact patient management and outcomes.
Why It's Important?
The nationwide coverage by Aetna represents a major advancement in the integration of AI technologies into mainstream healthcare. By providing a clear reimbursement pathway, this decision facilitates broader adoption of AI-driven diagnostic tools, which can enhance the accuracy and efficiency of coronary artery disease management. The move is likely to encourage other insurers to follow suit, potentially leading to widespread changes in how cardiovascular diseases are diagnosed and treated, ultimately improving patient outcomes and reducing healthcare costs.
What's Next?
With major insurers like Aetna, UnitedHealthcare, Cigna, and Humana now covering Heartflow's technology, healthcare providers will need to integrate this tool into their cardiology workflows. This integration will involve training and adjustments in clinical practice to maximize the benefits of the new reimbursement structure. As the technology becomes more widely used, further studies and data collection will be essential to refine its application and demonstrate its long-term benefits in patient care.
