National Coverage Analysis (NCA) Tracking Sheet

Microvolt T-wave Alternans



Microvolt T-wave Alternans (MTWA) testing is a non-invasive diagnostic test that detects minute electrical variability in a portion of the electrocardiogram (EKG) known as the T-wave. The spectral analysis method and the modified moving average method are different ways to measure microvolt-t wave alternans activity.

It has been suggested that such testing may have a role in assessing risk for sudden cardiac death from ventricular dysrhythmias and in determining subsequent patient management. Currently, Medicare nationally covers only MTWA using the spectral analysis method. The requestor, GE Healthcare, is asking CMS to reconsider the NCD to broaden national coverage to include the modified moving average method.

National Coverage Determinations

Benefit Category

Diagnostic Tests (other)

Requestor Information

Requestor NameRequestor Letter
GE Healthcare View Letter

Important Dates

Formal Request Accepted and Review Initiated
Expected NCA Completion Date
Public Comment Period
04/23/2014 - 05/23/2014
Proposed Decision Memo Released
Proposed Decision Memo Public Comment Period
10/23/2014 - 11/22/2014
Decision Memo Released
Comments for this NCA
View Public Comments


Lead Analysts
Kimberly Long
Lead Medical Officers
Joseph Hutter, MD, MA

Actions Taken

April 23, 2014

CMS opens this reconsideration of the NCD on MTWA testing. The formal request is to add the modified moving average method of determining MTWA to NCD Manual Section 20.30. 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 technology under review.

Instructions on submitting comments can be found at

October 23, 2014

January 13, 2015