On October 11, CMS released its final decision memorandum on the national coverage determination (NCD) for PTA of the Carotid Artery Concurrent with Stenting. The decision is in response to a request from the Multispecialty Carotid Alliance (MSCA) and comments received from SCAI and other organizations.

In the memo, CMS has accepted the request to make the guidelines less restrictive, including expanding coverage and removing facility and operator requirements. The complete list of changes, as stated in the memo are as follows:

• Expanding coverage to individuals previously only eligible for coverage in clinical trials
• Expanding coverage to standard surgical risk individuals by removing the limitation of coverage to only high surgical risk individuals
• Removing facility approval requirement
• Adding formal shared decision-making with the individual before furnishing CAS
• Allowing MAC discretion for all other coverage of PTA of the carotid artery concurrent with stenting not otherwise addressed in NCD 20.7.1.

SCAI is thrilled that CMS accepted our requested changes and created a policy to expand this procedure's access for Medicare beneficiaries.