A long-delayed final coverage policy has been released by the Centers for Medicare & Medicaid Services (CMS). It expands coverage for transcatheter edge-to-edge repair (TEER) procedures, to include patients with secondary (or functional) mitral regurgitation (MR) resulting from heart failure. Unlike the proposed coverage policy, it maintains the mandate for participation in registries and grants automatic coverage of off-label procedures in approved clinical trials. SCAI and allied societies recommended that this requirement be maintained in order to keep coverage of procedures in clinical trials and to continue to gather data on the outcomes of these procedures as indications expand. Of interest is a 10-year sunset provision for this coverage policy—CMS is anticipating that the coverage decisions will be delegated to Medicare Administrative Contractors after that time. Additional minor tweaks were made to volume requirements. Those changes should be reviewed by all providers and facilities performing mitral valve procedures.