Dismantling the Scaffolding: CMS Coverage of TAVR, 2012-2026, and the Future of the Heart Team

This white paper examines the evolution of Medicare’s coverage policies for transcatheter aortic valve replacement (TAVR) and explores the significant changes proposed by CMS in 2026. As TAVR expands to asymptomatic patients and longstanding evidence development and volume requirements are relaxed, healthcare leaders must balance broader patient access with the continued need for quality oversight, multidisciplinary collaboration, and long-term valve management.

Key Takeaways

• Reviews how CMS TAVR coverage requirements have evolved from 2012 through the proposed 2026 National Coverage Determination updates, including changes to Coverage with Evidence Development (CED), volume thresholds, and patient eligibility.
• Examines the future role of the multidisciplinary Heart Team as regulatory requirements shift toward greater local program accountability and governance.
• Analyzes the ongoing debate between expanding patient access and maintaining quality outcomes, particularly as TAVR moves into younger and asymptomatic patient populations

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