CMS sets Medicare payment for AI-enabled ECG analysis, boosting Viz.ai’s HCM detection tool

CMS to pay for AI ECG analysis: ©Yodiyim - stock.adobe.com

Viz.ai announced that the Centers for Medicare & Medicaid Services has established a national Medicare payment rate of $128.90 for AI-powered electrocardiogram (ECG) analysis, marking a milestone for artificial intelligence in cardiovascular diagnostics.

Effective Jan. 1, 2025, the payment applies to Category III CPT codes 0764T and 0765T, which were created by the American Medical Association CPT Editorial Panel to describe “electrocardiograph, computerized analysis with artificial intelligence, for detection of cardiac pathology.” These codes cover analysis of ECGs performed either concurrently or previously and enable reimbursement for AI tools like Viz HCM.

“This is a major milestone for AI in cardiovascular care,” said Jamie Stern, senior director of Care Pathways at Viz.ai. “Reimbursement for AI-powered ECG interpretation empowers clinicians to identify high-risk patients earlier, before symptoms progress or serious events occur—supporting more timely diagnosis, specialist referral, and treatment.”

Viz HCM uses deep learning algorithms to scan standard 12-lead ECGs and flag patterns suggestive of hypertrophic cardiomyopathy (HCM), an often undiagnosed but potentially deadly heart condition. The technology integrates into routine clinical workflows and aims to improve early detection and referral rates.

A recent study in JACC: Clinical Electrophysiology showed Viz HCM accurately identified 574 patients with HCM and, in 691 cases where HCM was ruled out, helped identify alternate diagnoses. The findings highlight the algorithm’s role in improving clinical decision-making and care coordination.

"Reimbursement is a meaningful step forward for the uptake of novel technologies,” said Joshua M. Lampert, FACC, cardiac electrophysiologist and medical director of Machine Learning at Mount Sinai Fuster Heart Hospital. “This development can provide institutions with a sustainable means to build and maintain the necessary infrastructure to provide safe and effective care for patients during an actively evolving health care modernization process."

The CPT codes were first introduced in 2023, but CMS had not assigned a national payment rate until now. With reimbursement secured, hospitals and health systems are expected to expand use of AI-ECG analysis in routine cardiovascular care.

Viz HCM is part of the Viz.ai One Platform, which connects real-time clinical data and care teams to accelerate diagnosis and streamline treatment for both cardiovascular and neurological conditions.

CMS’s embrace of AI signals shift in health tech reimbursement

The move by CMS to assign a national payment for AI-enabled ECG interpretation is part of a broader trend toward incorporating advanced technologies into reimbursable clinical workflows. This shift signals growing institutional trust in AI tools and lays the groundwork for more widespread adoption.

Until recently, many AI-driven diagnostic tools fell into a gray area, with no clear reimbursement path despite demonstrated clinical value. The assignment of Category III CPT codes provided a procedural identity, but without payment, hospitals faced financial barriers to implementation. By establishing a national rate, CMS has now created a sustainable model for institutions to integrate AI into daily operations.

The decision also reflects CMS’s broader strategy of encouraging innovation that improves care quality while potentially reducing long-term costs. Early detection of HCM, for instance, could prevent expensive emergency interventions, improve patient outcomes, and lower overall health care spending.

AI applications in health care are rapidly evolving beyond radiology and image analysis. Cardiology is emerging as a key frontier, with algorithms capable of detecting subtle cardiac abnormalities from routine diagnostics like ECGs. These tools not only assist in identifying conditions such as HCM, atrial fibrillation, or long QT syndrome but also help reduce variability in interpretation.

CMS has previously taken steps to support digital health innovation, including the use of remote patient monitoring and virtual care services. The reimbursement of AI-ECG analysis may accelerate additional coverage decisions for AI-driven tools in other specialties, from oncology to neurology.

As stakeholders look to modernize care delivery, the latest CMS ruling represents more than a payment—it affirms that artificial intelligence can be a legitimate, reimbursable part of clinical care.