November 3, 2026
Revised: NCD 20.32 – Transcatheter Aortic Valve Replacement
On September 10, 2026, CMS published a final decision memo
that updates National Coverage Determination (NCD) 20.32 – Transcatheter Aortic Valve Replacement (TAVR) to:
- Cover TAVR for symptomatic severe aortic valve stenosis (or aortic stenosis (AS)) without the coverage with evidence development (CED) requirement.
- Expand coverage of TAVR to asymptomatic severe AS with CED.
- Revise coverage criteria related to pre-procedural patient assessment, intraoperative requirements, and operator and hospital procedural volume requirements.
A Change Request (CR) to implement updates to the NCD and Internet-Only Manuals (IOMs) is forthcoming.
Until then, please refer to the final decision memo
for policy revision details and note that the following billing instructions are consistent with these changes.
For TAVR claims with dates of service on or after September 10, 2026:
- Type of Bill (TOB) 11X or Place of Service (POS) 21 only.
- Modifier 62 – Only required on Part B TAVR claims when the heart team determines joint participation is appropriate.
- 8-digit clinical trial identifier number and diagnosis code Z00.6 – Only required when asymptomatic severe AS is furnished in a CMS-approved CED study.
- TAVR claims submitted with CED claim information will continue to process according to applicable CED claims processing requirements (Medicare Claims Processing Manual (Pub. 100-04), Chapter 32, section 69
).

