Medicare Cardiac CT Payments Declined Through 2026
Medicare reimbursement for heart imaging tests fell significantly even as patient usage of these scans increased.
Updated on Sept. 30, 2026 in Heart Disease
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Between 2010 and 2026, inflation-adjusted Medicare payments for various cardiac computed tomography (CT) services dropped by 27% to 68%. This change occurred alongside a major surge in the use of coronary CT angiography, which saw its procedure volume rise by 408% from 2013 to 2024.
Why it matters
The decline in reimbursement rates may influence how healthcare systems balance the increasing demand for advanced heart imaging with the financial realities of providing these diagnostic tests. As volume grows, understanding these payment trends is essential for tracking the sustainability of cardiac care delivery.
A retrospective analysis published in the Journal of Cardiovascular Computed Tomography on September 30, 2026, tracked Medicare payment shifts from 2010 through 2026. The findings show significant real-dollar reductions across multiple cardiac CT categories compared to historic baseline values.
The players
Medicare
The federal health insurance program for older adults and people with disabilities that sets payment rates for medical services.
American Heart Association (AHA)
A national organization focused on heart health that issues guidelines for clinical practice and cardiovascular care.
American College of Cardiology (ACC)
A professional medical society that establishes clinical standards and recommendations for cardiovascular medicine.
Mayo Clinic
A nonprofit medical center known for clinical research and patient care where the study team conducted their analysis.
The details
Researchers calculated payment changes by multiplying total relative value units by the annual conversion factor to determine non-facility, inflation-adjusted charges. While the average real allowed charge per coronary CT angiography service fell by 45.9% between 2013 and 2024, total real fee schedule spending still rose by $22.0 million. This overall increase was driven by a $51.4 million volume effect, which outweighed the downward pressure from unit revenue and interaction effects.
Timeline
2010-2026: Period of Medicare payment decline.
2011: The year that saw the largest single-year payment reduction.
2013-2024: Volume of coronary CT angiography rose by 408%.
2021: AHA/ACC guidelines issued a Class 1 recommendation for these tests.
September 30, 2026: Research published in the Journal of Cardiovascular Computed Tomography.
Health Landscape
The rise in imaging volume follows the adoption of the 2021 AHA/ACC guidelines that established a Class 1 recommendation for using CT imaging in cardiac workups. This shift reflects a broader evolution toward more precise, non-invasive diagnostic tools in the standard of care for heart disease.
If you are scheduled for a cardiac CT scan, these payment shifts generally do not affect your personal out-of-pocket costs, which are determined by your specific insurance plan. It is always worth discussing the necessity of any heart imaging with your doctor to understand why it is recommended.
The takeaway
Cardiac CT remains a vital tool for heart health that has become more accessible as its use in clinical practice has grown. Patients should focus on following their physician's guidance regarding necessary diagnostic screenings for heart disease risk management.
Further reading
For more on the latest diagnostic standards, visit Heart Disease.
Source note: This article includes information reported by AuntMinnie.
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