Heartflow, Inc. announced Heartflow Plaque Analysis is now covered by Aetna across all lines of business, including Commercial, Medicare Advantage, and Aetna Better Health Medicaid plans. Aetna is the fourth major national commercial insurer to update its policies to cover Heartflow Plaque Analysis to fully align with the guidelines issued by radiology benefit manager EviCore, following similar decisions by Humana, Cigna, and UnitedHealthcare. Heartflow Plaque Analysis is covered for the majority of insured lives across the United States.
This coverage milestone follows the American Medical Association's recent implementation of the new Category I Current Procedural Terminology (CPT®?) payment code 75577 for Heartflow Plaque Analysis, effective January 1, 2026, which established 0.85 relative value units (RVUs) and a combined total of 4.00 RVUs for physicians performing the service. The updated coverage became effective on December 23, 2025 for Aetna patients with acute or stable chest pain and mild-to-moderate narrowing of coronary arteries (1-69% stenosis) identified on coronary CTA. The policy expands access for patients to AI-driven plaque analysis, supporting earlier diagnosis, personalized riskstratification, and more precise management of CAD.
The new CPT code was issued in response to increased utilization of AI-powered plaque quantification and characterization technology like Heartflow Plaque Analysis and strong clinical evidence supporting its value. Together, broader national payer coverage and Category I reimbursement position the Heartflow platform as the highest-value pathway in cardiac CT, expanding access and supporting practical adoption in clinical practice. Heartflow's continued advancement of Heartflow Plaque Analysis builds on the real-world evidence demonstrated in the landmark DECIDE Registry data, the largest prospective registry evaluating the clinical impact of Heartflow Plaque Analysis on medical management decisions.
The DECIDE registry showed that more than 50% of patients had their medical management changed when Heartflow Plaque Staging was added compared to their management based on CCTA alone. A retrospective analysis of symptomatic patients from a cohort of the FISH&CHIPS Study presented at the AHA Scientific Sessions 2025 provided the largest validation to date of the Heartflow Plaque Staging framework based on total plaque volume measurement as a predictor of future heart attacks or cardiovascular death. Heartflow Plaque analysis is the only FDA-cleared, AI-powered plaque quantification tool with 95% agreement to the gold standard, IVUS, using blinded core lab adjudication.
