ASE Joins Comments on TAVR National Coverage Determination

On July 13, ASE joined the Heart Valve Disease Policy Task Force, a national group of 30 clinician and patient advocacy leaders, in submitting comments to CMS on the proposed National Coverage Decision memo for Transcatheter Aortic Valve Replacement (TAVR). The letter commends CMS for updates reflecting the maturity of TAVR’s evidence base, including national coverage for symptomatic severe aortic stenosis without Coverage with Evidence Development (CED), elimination of facility volume requirements, clarified operator volume requirements, streamlined patient evaluation allowing a single in-person specialist assessment with remote review for the second, and greater Heart Team flexibility. While supporting these changes, the Task Force expresses concern that CED would remain in place for asymptomatic severe AS, noting that emerging evidence supports earlier intervention, and urges CMS to establish a pathway toward broader national coverage as evidence develops.

This NCD directly affects ASE members, as echocardiography is central to the diagnosis, severity assessment, and procedural planning for aortic stenosis and TAVR candidacy. Streamlined evaluation requirements and expanded site access will increase demand for timely, high-quality echocardiographic assessment, particularly in rural and underserved communities gaining access to TAVR programs. ASE’s participation reinforces its advocacy for coverage policies that reduce barriers to care while preserving the rigorous imaging-based evaluation essential to appropriate patient selection and optimal outcomes.