SVS VQI Reports Expansion of CMS Coverage to Standard Surgical Risk Patients Within the TCAR Surveillance Project

June 14, 2022—The Society for Vascular Surgery (SVS) Vascular Quality Initiative (VQI) announced that the Centers for Medicare & Medicaid Services (CMS) has expanded coverage for transcarotid artery revascularization (TCAR) to include standard surgical risk patients within the VQI TCAR Surveillance Project. The approval, which became effective May 31, 2022, was a combined effort of the SVS VQI and the SVS Patient Safety Organization (PSO) and should allow for enhanced patient treatment moving forward.

Reimbursement for TCAR within the TCAR Surveillance Project will now apply to Medicare beneficiaries who are deemed to be at high risk and standard risk for adverse events from carotid endarterectomy (CEA). Hospitals and physicians participating in the TCAR Surveillance Project can obtain reimbursement for TCAR procedures by submitting claims under the existing National Clinical Trial number, NCT02850588.

The SVS VQI will be available for discussions at Booth 610 at the SVS 2022 Vascular Annual Meeting held June 15-18 in Boston, Massachusetts. More information is also available online at https://www.vqi.org.

As noted by the SVS VQI, the TCAR Surveillance Project, launched in 2016 by the SVS PSO, uses real-world registry data to evaluate the safety and effectiveness of TCAR against standard-of-care CEA. Initial publications and data analysis suggest TCAR, in which a stent is inserted into the internal carotid artery through a small neck incision via the common carotid artery, has a lower stroke rate than the transfemoral carotid artery stent (CAS) technique.

The VQI TCAR Surveillance Project is directed by a SVS PSO Steering Committee that makes periodic analyses of data collected in the VQI CAS and CEA Registries. The expanded coverage for standard surgical risk patients will enable SVS VQI participating centers to extend the benefits of TCAR to a wider population of carotid artery disease patients and allow evaluation of outcomes in this broader patient population.

Marc Schermerhorn, MD, who serves as SVS PSO Steering Committee Chair, commented in the press release, “This is wonderful news for patients as TCAR is a minimally invasive treatment with major complication rates equivalent to, or lower than, the standard surgical procedure, CEA.”

Dr. Schermerhorn continued, “While the best course of action for patients will vary based on anatomy, the less invasive TCAR option will be more appealing than endarterectomy for many, if not most, patients. This is an excellent demonstration of the value of the VQI and its collaboration with the FDA and industry to answer important questions and accelerate the availability of new technology to the population.”

Jens Eldrup-Jorgensen, MD, Medical Director of the SVS VQI, stated, “The new coverage decision will allow providers to offer TCAR to all patients who they feel would benefit from the TCAR approach. Therefore, the choice of intervention will be dependent on provider and patient preference and will not be limited by predefined criteria for coverage.”