SCAI 2026 Building and Sustaining Your RDN Program-RDN and Reimbursement: What Providers Need to Know, Dr. Aronow

Video Transcription

Video Summary

The speaker explains U.S. coverage and payment for renal denervation (RDN). Initially, new technologies are reviewed case by case by Medicare contractors, but RDN now has a national coverage determination under coverage with evidence development. The NCD sets strict requirements for patients: confirmed uncontrolled hypertension, documented primary care follow-up, lifestyle changes, stable maximal medical therapy, and exclusion of contraindications. Facilities must have trained personnel, imaging access, and processes to verify eligibility. Operators need endovascular expertise, proctoring, and case experience.<br /><br />For payment, facility and physician reimbursement are separate. Hospitals can be paid under inpatient or outpatient Medicare systems, with temporary add-on payments helping offset device costs. Physician payment is harder because RDN currently uses a Category 3 CPT code with no national valuation, so clinicians may need to crosswalk to similar procedures to justify RVUs. Commercial and Medicare Advantage payers negotiate separately, and broad long-term payment stability likely depends on conversion to a Category 1 code.

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Keywords

renal denervation

Medicare coverage

coverage with evidence development

CPT Category 3 code

physician reimbursement