Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease

FFRct is covered primarily for intermediate‑risk patients (per 2021 AHA/ACC guideline) with acute or stable chest pain when CCTA demonstrates 40–90% stenosis in proximal or mid coronary arteries, and for selected patients with stable nonobstructive CAD or persistent ischemic symptoms despite maximally tolerated medical therapy. It must be performed only after a completed/interpreted CCTA (with images submitted for off‑site post‑processing) and is intended as an alternative to stress testing; FFRct is not reasonable for many scenarios including prior stents, CABG grafts, prosthetic valves, recent MI (≤30 days), suspected ACS, certain device leads, certain left‑main or low‑grade lesions (<40%), or when processing turnaround would delay care.

"FDA‑approved FFRct is reasonable for intermediate‑risk patients (per 2021 AHA/ACC et al."

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