Elucid Gains Broad CMS Reimbursement of Coronary Plaque Analysis Using PlaqueIQ™

New CPT I Code, OPPS and MPFS Decisions Recognize Significant Clinical Value Across Care Settings

BOSTON--(BUSINESS WIRE)--Elucid has announced new Hospital Outpatient Prospective Payment (OPPS) and Physician Fee Schedule (PFS) decisions from the U.S. Centers for Medicare & Medicaid Services (CMS) that establish significant reimbursement for coronary plaque analysis using PlaqueIQ across care settings. The final rules, effective January 1, 2026, include a new Category I CPT code (75577) for AI quantification and characterization of coronary atherosclerotic plaque derived from analysis of CCTA, with a national average payment amount of $1,021 for use in imaging centers and physician offices. The 2026 OPPS payment rate was set at $951 for use in hospital outpatient settings.

Together, these decisions enable widespread use of clinically validated technologies like Elucid’s PlaqueIQ™, the only plaque analysis technology validated in ground truth histology, the gold standard for plaque characterization, that can help non-invasively quantify and classify coronary artery plaque and its components such as lipid rich necrotic core (LRNC), giving potential insights into high-risk plaques that are key drivers of risk of heart attack and stroke.^1,2 Powered by CT Virtual Histology™ (CT-VH™), PlaqueIQ is designed to help physicians prioritize and personalize treatment based on actual coronary artery disease, rather than population-based risk.

“The CY 2026 CMS final rules are great news for clinicians and their patients who will now have broad access to innovative, evidence-based imaging tools that help identify high-risk cardiovascular individuals earlier and more accurately,” said Elucid’s CEO Kelly Huang. “At Elucid, our mission is to dramatically reduce the burden of heart attack and stroke, and we are grateful that CMS sees the value of coronary plaque analysis like PlaqueIQ and the role it plays towards achieving this goal.”

Elucid is planning for the commercial launch of its complementary FFR_CT offering in 2026 (pending FDA clearance). Also exclusively based on CT-VH, the software will be covered by Category I code 75580. Recently, Elucid also announced the launch of carotid PlaqueIQ, the first and only CT-based plaque analysis indicated for the carotid anatomy that can help physicians assess risk of rupture and ischemic stroke.

About Elucid

Elucid is a Boston-based AI medical technology company dedicated to developing technology designed to provide physicians with a more precise view of atherosclerosis (coronary and carotid plaque buildup), the root cause of cardiovascular disease. The company’s PlaqueIQ^™ image analysis software is designed to help physicians prioritize and personalize treatment based on actual disease, rather than population-based risk of disease. PlaqueIQ includes the only FDA-cleared computed tomography angiography (CTA) algorithm that objectively quantifies plaque morphology validated against ground truth histology, the gold standard for characterization of plaque, as indicated by renowned pathologists. PlaqueIQ equips physicians with critical information regarding the type and amount of plaque in arteries that can lead to heart attack and stroke. Elucid’s FFR_CT product, which is pending FDA clearance, is derived from Elucid’s plaque algorithm, resulting in concordance between plaque and FFR_CT. FFR_CT helps physicians identify coronary blockages and the extent of a patient’s ischemia non-invasively. For more information, visit elucid.com.

References:

¹ https://www.ahajournals.org/doi/10.1161/01.ATV.20.5.1262
² https://pubmed.ncbi.nlm.nih.gov/39600843/