SVS' Preliminary Response to CMS' Decision Regarding NCD 20.7

Oct 19, 2023

The Society for Vascular Surgery (SVS) is disappointed with the Centers for Medicare & Medicaid Services (CMS) decision to finalize its proposal for expanded coverage for Percutaneous Transluminal Angioplasty (PTA) of the Carotid Artery Concurrent with Stenting (NCD 20.7) without any substantive revisions.

We believe the coverage expansion outlined in the updated NCD 20.7 is premature given the pending results of the National Institutes of Health-funded CREST 2 (The Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Study) Trial and holds significant potential to increase risk in achieving quality of care and patient safety, particularly for our most vulnerable elderly patients.  

SVS remains concerned about the potential impact of this decision and will continue to stress the fundamental importance of vigilant reporting and monitoring of outcomes, requiring requisite training and experience in patient selection and performance of the procedure, and the need for a verified multi-specialty “Shared Decision Making” tool, which is referenced in the decision but does not yet exist.

The SVS will continue to actively promote quality and safety for the care of vascular patients through its published guidelines, appropriate care documents, and Patient Safety Organization-Vascular Quality Initiative (PSO-VQI) Registry and quality initiatives such as the Vascular Verification Program.

The SVS will continue to make its tools and resources widely available.  A more comprehensive statement from SVS is forthcoming.

The SVS will continue to make its tools and resources widely available.