Multisociety Comments Submitted to CMS on Proposed Decision on NCD for TAVR

July 20, 2026—The Society for Cardiovascular Angiography & Interventions (SCAI) announced that, in collaboration with the American College of Cardiology (ACC) and the Society of Thoracic Surgeons (STS), the societies have submitted comments to the Centers for Medicare and Medicaid Services (CMS) on areas needing clarification in the CMS proposed decision on the National Coverage Determination (NCD; CAG-00430R2).

CMS issued its proposed decision memo for transcatheter aortic valve replacement (TAVR) on June 15 and commenced the final 30-day comment period on changes to the NCD. CMS has stated its final decision memo should be released approximately on September 15, 2026, noted SCAI.

SCAI advised that most of the proposed changes aligned with its member survey.

According to the SCAI/ACC/STS letter, the societies support modernizing the NCD and offer the following recommendations for promoting high-quality, evidence-based, and patient-centered care:

• Preserve the multidisciplinary heart team model by explicitly requiring evaluation of eligible patients with severe aortic stenosis by both an interventional cardiologist and a cardiac surgeon and maintaining collaborative decision-making as a required component of care.
• Maintain a targeted coverage with evidence development (CED) pathway for patient populations where important evidence gaps remain, including bicuspid aortic stenosis, valve reintervention, asymptomatic severe aortic stenosis, aortic regurgitation, and moderate aortic stenosis.
• Maintain mandatory participation in a national audited registry, such as the STS/ACC TVT Registry, and clarify how registry participation may be used to satisfy CED requirements as well as support quality measurement requirements.
• Preserve nationally standardized approaches to quality measurement, benchmarking, and continuous quality improvement through registry participation and externally benchmarked performance assessment while adopting a programmatic approach to facility and operator requirements that prioritize institutional performance, multidisciplinary infrastructure, and quality outcomes over rigid operator volume thresholds alone.

The societies stated that these recommendations focus on targeted clarifications to the proposed decision that will help ensure consistent implementation, preserve nationally standardized approaches to quality assessment and evidence generation, and maintain the multidisciplinary care model that has contributed to the success of TAVR in the Medicare population.

Additional details regarding these recommendations and specific policy modifications are provided in the societies’ letter to CMS, which is available online here.