Transcatheter Tricuspid Valve Replacement (TTVR)

CMS covers transcatheter tricuspid valve replacement (TTVR) only when the procedure is performed for symptomatic tricuspid regurgitation despite optimal medical therapy, according to an FDA market-authorized indication, and when the patient is managed by a multidisciplinary heart team. Coverage is limited to treatments furnished within a CMS‑approved Coverage with Evidence Development (CED) study that meets specified outcome, comparator, subgroup, reporting, data-sharing, governance, and AHRQ scientific standards; TTVR is not covered outside such CMS‑approved studies except as allowed under other applicable policies (e.g., NCD 310.1 or IDE).

"Patient has symptomatic tricuspid regurgitation despite optimal medical therapy (OMT) and tricuspid valve replacement is considered appropriate by a heart team."

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