National Coverage Analysis (NCA) Tracking Sheet

Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD)

CAG-00449N

Issue

CMS received an NCA request to establish a national coverage determination (NCD) for coverage of supervised exercise therapy (SET) for the treatment of peripheral artery disease (PAD).

PAD is a cardiovascular disease that occurs when plaque buildup narrows the arteries outside the heart. PAD most commonly affects the lower extremities and can cause claudication (pain/discomfort) in the legs during exercise, but can also occur while at rest if the disease worsens. Individuals suffering from claudication due to PAD will often limit their walking to avoid/relieve symptoms which could dramatically impact their quality of life (i.e., loss of functional independence, abandoning hobbies, increased isolation, etc.). SET is a low risk and non-invasive treatment option and is indicated for patients with documented PAD and claudication.

Endovascular procedures and medical therapy are beyond the scope of this NCA.

CMS is soliciting public comment relevant to this NCA. We are particularly interested in comments that include scientific evidence.

Benefit Category

Incident to a physician's professional Service
Outpatient Hospital Services Incident to a Physician's Service
Physicians' Services

Requestor Information

Requestor Name Requestor Letter
American Heart Association (AHA) View Letter
N/A

Important Dates

Formal Request Accepted and Review Initiated
09/15/2016
Expected NCA Completion Date
05/31/2017
Public Comment Period
09/15/2016 - 10/15/2016
Proposed Decision Memo Due Date
Proposed Decision Memo Released
03/02/2017
Proposed Decision Memo Public Comment Period
03/02/2017 - 04/01/2017
Decision Memo Released
05/25/2017
Comments for this NCA
View Public Comments

Contacts

Lead Analysts
David Dolan, MBA, MA
david.dolan@cms.hhs.gov
410-786-3365
Lead Medical Officers
Jyme Schafer, MD, MPH

Medicare Benefit Category Determination Date

Actions Taken

September 15, 2016

CMS initiates this national coverage analysis for Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD). The initial 30-day public comment period begins with this posting date, and ends after 30 calendar days. CMS considers all public comments, and is particularly interested in clinical studies and other scientific information relevant to the topic under review.

Instructions on submitting comments can be found at: http://www.cms.gov/Medicare/Coverage/InfoExchange/publiccomments.html.

To submit a comment, please use the orange "Comment" button at the top of the page. Enter comments directly into the "Submit A Public Comment" webpage.

March 2, 2017

May 25, 2017

Posted final decision memo.