Cardio Diagnostics Holdings, Inc. Receives Preliminary Medicare Pricing from Centers for Medicare and Medicaid Services (CMS) for AI-Powered Cardiovascular Tests

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Preliminary CMS pricing determination marks a key milestone in gaining broad access to Medicare reimbursement.

CHICAGO, October 01, 2024--(BUSINESS WIRE)--Cardio Diagnostics Holdings, Inc. (NASDAQ: CDIO), an AI-driven precision cardiovascular medicine company today announced that the Company’s PrecisionCHD and Epi+Gen CHD tests have received preliminary pricing determinations from the Centers for Medicare & Medicaid Services (CMS). This determination represents a crucial step toward securing Medicare reimbursement, enabling access to the Company’s affordable, innovative, and highly scalable blood tests aimed at improving the risk assessment, diagnosis, management and monitoring of coronary heart disease (CHD) for Medicare patients.

CMS recently issued a preliminarily determination to price both PrecisionCHD and Epi+Gen CHD on a ‘gapfill’ basis. This decision, following the Clinical Laboratory Fee Schedule (CLFS) Annual Public Meeting held on June 25, 2024, recognizes the unique value of these tests. If finalized, this decision will be effective for claims with dates of service on or after January 1, 2025, and will allow Medicare contractors to determine pricing for PrecisionCHD and Epi+Gen CHD based on actual cost data from Cardio Diagnostics. The Medicare contractors will report to CMS preliminary gapfill pricing for calendar year 2025 by April 1, 2025.

"We are proud to reach this important milestone with CMS, bringing us closer to making our cutting-edge cardiovascular tests accessible to Medicare patients," said Meesha Dogan, Ph.D., CEO and Co-Founder of Cardio Diagnostics. "This determination underscores the value of innovation in healthcare, and we’re excited to support clinicians with advanced tools that can enhance the diagnosis and management of coronary heart disease, ultimately improving outcomes for one of the most at-risk populations."

Cardiovascular disease is the leading cause of death in the United States, including among Americans over 65 years old. In 2022, the number of deaths due to heart disease was 702,880, with a mortality rate of 211 deaths per 100,000 population. Coronary heart disease, the most common type of heart disease, claimed 371,506 lives. PrecisionCHD is an AI-powered blood test that aids in the diagnosis of coronary heart disease (CHD) by evaluating genetic and epigenetic markers. Epi+Gen CHD assesses the three-year risk for a CHD event, including heart attacks, using a similar AI-driven integrated genetic-epigenetic approach. Both tests received dedicated CPT Proprietary Laboratory Analysis (PLA) codes from the American Medical Association, 0439U for Epi+Gen CHD and 0440U for PrecisionCHD, that were effective on April 1, 2024.