Medicare's New NTAP for AI Cardiac Amyloidosis Detection: What the FY 2027 Final Rule Means for Your Hospital

On August 4, 2026, CMS published the fiscal year 2027 IPPS final rule, and with it a decision we are proud to share: Medicare has approved a New Technology Add-on Payment (NTAP) for InVision Precision Cardiac Amyloid, our FDA-cleared AI software for detecting cardiac amyloidosis from routine echocardiograms. Beginning October 1, 2026, hospitals using InVision PCA on eligible Medicare inpatient cases can receive up to $2,275 per stay, paid in addition to the standard MS-DRG payment.

Cardiac amyloidosis is a rare but underdiagnosed cause of heart failure. A Swedish study found a mean delay of 3.5 years between a patient's first cardiac-related presentation and the point at which their ATTR-CM is identified.² New, effective treatments are available, but their efficacy decreases as the disease progresses. Quite simply: the disease burden is the delay to detection. Every hospital in the country wants to improve cardiac amyloid detection, but has to wrestle with the question of "who pays" for the tools and technology that can improve accurate detection. CMS has now answered that question definitively for the detection of cardiac amyloidosis using InVision's FDA-cleared AI.

What the FY 2027 IPPS Final Rule Actually Says

The NTAP was granted to InVision Precision Cardiac Amyloid (InVision PCA) by name. This matters, and it is worth reading the language CMS published in the final rule directly.

On the approval itself:

"Based on the information provided in the application for new technology add-on payments, and after consideration of the public comments we received, we believe InVision PCA meets the cost criterion. The technology received marketing authorization from FDA as a Breakthrough Device on May 21, 2025 for the indication covered by its Breakthrough Device designation. Therefore, we are finalizing our proposal to approve new technology add-on payments for InVision PCA for FY 2027."

— CMS, FY 2027 IPPS Final Rule (CMS-1849-F)¹

On the payment amount:

"…we are finalizing that the maximum new technology add-on payment for a case involving the use of InVision PCA is $2,275.00 for FY 2027."

— CMS, FY 2027 IPPS Final Rule¹

And on how eligible cases are identified:

"The applicant was granted approval for a unique ICD-10-PCS procedure code for the InVision PCA beginning in FY 2027. Therefore, cases involving the use of InVision PCA that are eligible for new technology add-on payments will be identified by ICD-10-PCS procedure code: XEZZXLC (Computer-aided detection and notification for imaging abnormalities in echocardiography, new technology group 12)."

— CMS, FY 2027 IPPS Final Rule¹

InVision Precision Cardiac Amyloid is the only echocardiography technology approved for a new technology add-on payment in fiscal year 2027, and eligibility for the payment is defined by the use of InVision PCA. Our algorithm analyzes multiple videos in an echocardiogram study and incorporates information about both wall thickness and echotexture in the analysis. In the one published head-to-head evaluation, it delivered the highest specificity and positive predictive value of the approaches tested⁴ — which means fewer false positives and fewer erroneous alerts. (For the full operating-point comparison, including sensitivity, see our amyloid evidence page and comparison of amyloid AI.)

Why NTAP Exists

Congress created the New Technology Add-on Payment program in 2000 to solve a structural problem in how Medicare pays hospitals. Under the Inpatient Prospective Payment System (IPPS), hospitals receive a fixed MS-DRG payment per discharge based on historical cost data. That works well for established care, but it cannot account for the cost of new technologies — the MS-DRG rates are built from claims that, by definition, could not have factored in the cost of a technology that did not yet exist.

NTAP helps bridge that gap. For a limited window — typically two to three years while claims data catches up — Medicare pays hospitals an add-on amount for cases that use a qualifying NTAP technology. To earn the designation, a technology must be considered new, represent a substantial clinical improvement over existing options, and meet a charge threshold. As Software as a Medical Device (SaMD) with FDA Breakthrough Device Designation, InVision PCA meets these criteria. The NTAP program approves technologies on the strength of their specific application, background, and evidence.

InVision was the only NTAP applicant in FY 2027 for an echocardiography-based technology. InVision PCA uses multiple views from an echocardiogram study to detect both AL and ATTR cardiac amyloidosis — because the signals of amyloidosis show up across a study, not in a single view. It reads both the parasternal long-axis and apical four-chamber views, analyzing echotexture and wall thickness, where conventional or single-view workflows offer limited specificity. That multi-view approach is what gives InVision PCA the high positive predictive value to flag patients at high suspicion of cardiac amyloidosis.

Every echo lab director asks the same question once the clinical case is settled: who pays. As of October 1, that question has an answer.

In short, the NTAP is Medicare's mechanism for easing the financial disincentives that IPPS creates for qualifying new technologies — which in turn opens access to those technologies for Medicare patients. We can think of no better fit for that mandate than a disease that hides in plain sight on tests hospitals already perform. InVision PCA started as a JAMA Cardiology paper in 2022³ and led the wave in using echo AI to detect under-recognized disease. One of the first approaches to use AI to re-review echocardiogram studies already obtained for other clinical reasons, InVision PCA helps close gaps in the detection of rare disease.

How the Payment Works

There are no special billing requirements beyond coding: the hospital reports ICD-10-PCS code XEZZXLC on the inpatient claim for a case where InVision PCA was used, and the Medicare Administrative Contractor's claims system calculates the add-on automatically.

The payment itself is calculated case by case. Medicare pays the lesser of 65 percent of the cost of the technology ($2,275) or 65 percent of the amount by which the total covered costs of the case exceed the operating portion of the MS-DRG payment.⁵ In practice, that produces three scenarios:

• Costs do not exceed the MS-DRG payment. The DRG payment already covers the reported cost of the stay, and the add-on is $0. The hospital is paid in full through the DRG.
• Costs exceed the DRG payment by a modest amount. Medicare pays 65 percent of the excess — an add-on greater than $0 but below the cap of $2,275.
• Costs exceed the DRG payment substantially. Medicare pays the full capped amount of $2,275 in addition to the DRG payment.

The same three discharges, step by step:

Also note that the total MS-DRG payment will be greater than the examples shown above, as capital and other relevant payment adjustments are included in the total hospital MS-DRG payment amount. CMS provides a web-based tool that estimates hospital-specific MS-DRG payments and factors in any potential NTAP payment, available at webpricer.cms.gov.⁶

Because cardiac amyloidosis so often presents alongside heart failure and other high-acuity admissions, the cases where InVision PCA changes a diagnostic trajectory are frequently the cases where costs run well above the DRG payment. The NTAP is designed for exactly those stays.

One more design point worth knowing: the NTAP is not tied to any particular condition or MS-DRG. Eligibility follows the use of the technology, documented through XEZZXLC, across the full range of admissions where an echocardiogram is performed and the algorithm is applied.

Beyond the Inpatient Setting: CPT 0932T

The NTAP covers Medicare inpatient stays. For the hospital outpatient department and physician office — where the majority of echocardiograms are performed — use of InVision Precision Cardiac Amyloid is reported under Category III CPT code 0932T in studies with an LVEF above 50%, active since January 1, 2025. The JAMA Cardiology 2022 paper that laid the foundation for InVision PCA was an instrumental part of the package to secure 0932T, and part of the clinical evidence demonstrating the value of echo AI.

Taken together, NTAP on the inpatient side and 0932T on the outpatient side give Precision Cardiac Amyloid a defined Medicare payment pathway across both settings of care. Health systems no longer need to choose between doing the right thing clinically and defending an unfunded line item.

Why This Disease, and Why This Technology

Cardiac amyloidosis is a progressive, life-threatening disease that is dramatically underdiagnosed because its signs overlap with far more common causes of heart failure. Patients routinely see multiple specialists over multiple years before the disease is identified, and every year of delay narrows the window in which today's disease-modifying therapies can do the most good.

The opportunity for change is that the evidence of cardiac amyloidosis is frequently already sitting in the echocardiogram. InVision PCA applies machine learning to two standard transthoracic views — the apical four-chamber and the parasternal long-axis — from studies that are already being acquired every day, and alerts the interpreting physician when a patient shows high suspicion of cardiac amyloidosis so they can be referred for confirmatory workup. It is indicated for adults aged 65 and over undergoing cardiovascular assessment with echocardiography, with no prerequisite heart-failure history and no wall-thickness requirement. The underlying algorithm was published in JAMA Cardiology in 2022,³ and in a 2025 head-to-head evaluation published in JACC: Advances⁴ it delivered twice the positive predictive value of a comparator algorithm and rules-based approaches on the same patient cohort. In the context of an echo-AI cardiac amyloid detection program, that means fewer false positives and fewer patients made to worry and sent for unnecessary confirmatory testing that uses scarce resources and overloads clinics.

Getting Started

The NTAP takes effect for discharges on or after October 1, 2026. If your team is planning for the new fiscal year, now is the right time to get the details in front of your service line, echo lab, revenue cycle, and IT organizations.

One more point for planning teams: the NTAP is a bridge, not a permanent feature of the payment landscape. The window for capturing this payment is open now, and health systems that stand up their cardiac amyloid detection programs ahead of October 1, 2026 will capture it from the first eligible discharge.

Our full coding and payment guidance, including NTAP and CPT 0932T details, is available on our reimbursement page. If you would like to see the platform and review a value analysis for your health system, request a demo and we will walk you through it.