Final rule establishes national reimbursement under OPPS for AI-assisted cardiac analysis, enabling earlier cardiac disease detection in routine outpatient care
Eko Health, a leader in AI-powered cardiac and pulmonary care, announced that the Centers for Medicare & Medicaid Services (CMS) has finalized national payment for its SENSORA platform under the Outpatient Prospective Payment System (OPPS). The decision grants payment for SENSORA exams performed in outpatient settings, ensuring hospitals and health systems can receive reimbursement for AI-enabled cardiac detection delivered at the point of care.
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The finalized rule establishes a national payment rate recognizing the clinical and economic value of using artificial intelligence to support the early identification of heart disease within standard outpatient workflows. This follows CMS’s July 2025 proposed rule, which first assigned SENSORA’s Category III CPT code (0962T) to APC 5734. The inclusion in the final rule reflects growing institutional support for AI tools that strengthen front-line cardiac evaluation.
“This is a defining step toward making AI-assisted cardiac disease detection accessible to more patients across the country,” said Connor Landgraf, Co-founder and Chief Executive Officer at Eko Health. “The CMS ruling confirms that earlier cardiac disease detection is clinically valuable and will now be financially supported, allowing hospitals and clinicians to integrate this technology sustainably into everyday care. We are proud to help advance the national effort to reduce preventable cardiac deaths through smarter, more connected care.”
Heart disease remains the leading cause of death in the United States, accounting for nearly one in five deaths, according to the CDC. Many conditions, such as heart failure with reduced pump function (low ejection fraction), valvular heart disease, and atrial fibrillation, remain undetected until symptoms progress. SENSORA helps clinicians identify these conditions within seconds during a standard cardiac exam, providing timely information that can improve treatment decisions and care coordination.
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“The recognition from CMS underscores the growing clinical trust in AI technology and its real-world benefit for patients,” said Dr. Steven Steinhubl, cardiologist and Chair of Eko Health’s Clinical Advisory Board. “This ruling makes it possible for health systems to adopt tools like SENSORA in routine outpatient visits and give clinicians immediate access to information that can change the course of care.”
SENSORA’s algorithms have been validated in peer-reviewed studies published in leading medical journals, including The Lancet Digital Health, Nature Medicine, JACC Advances, Circulation, and the Journal of the American Heart Association. These studies demonstrate that AI-enabled cardiac analysis can help clinicians identify patients at risk for heart failure and valvular heart disease during a single stethoscope exam.
Eko Health will continue to collaborate with hospitals, integrated health networks, and payer partners to support adoption, training, and reimbursement readiness across outpatient and ambulatory care settings.
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Source- businesswire
