CMS Updates Medicare Coverage Requirements for TAVR

The Centers for Medicare & Medicaid Services (CMS) finalized an updated National Coverage Determination (NCD) for transcatheter aortic valve replacement (TAVR), according to an American College of Cardiology (ACC) report. The policy changes Medicare coverage requirements for patients with aortic stenosis.

TAVR for symptomatic severe aortic stenosis is now covered without Coverage with Evidence Development (CED), while coverage for asymptomatic severe aortic stenosis remains limited to CMS-approved CED studies and requires an FDA-approved indication. The ACC reported that no CMS-approved CED studies for asymptomatic disease currently exist, meaning TAVR is not yet covered for these patients.

The revised policy permits greater flexibility in Heart Team evaluations, including asynchronous review, but both an interventional cardiologist and cardiac surgeon must contribute to treatment decisions. CMS also removed the requirement that both specialists jointly perform every procedure. The Heart Team may determine whether one or two operators are appropriate.

Hospital TAVR volume thresholds were eliminated, while individual operators must perform at least 20 transcatheter cardiac valve procedures annually, including at least 15 TAVR procedures, or at least 30 TAVR procedures over 2 years. Requirements for on-site interventional cardiology services, surgical backup, and intensive care capabilities remain in place.

Registry participation is no longer required as a condition of Medicare coverage. Hospitals must instead maintain a continuous quality-improvement process that assesses procedural outcomes and makes program changes needed to support patient safety; registry participation may satisfy that requirement. CMS implementation guidance remains pending, and the ACC said additional details are expected in the coming months.

Source: American College of Cardiology. CMS finalizes updated TAVR national coverage determination. Published September 16, 2026. Accessed September 20, 2026.