HeartFlow announced that its Plaque Analysis platform will be covered by Aetna across all lines of business—Commercial, Medicare Advantage, and Medicaid—effective December 23 2025. The coverage applies to patients with 1‑69% coronary stenosis on coronary CTA and is supported by a new Category I CPT code (75577) that became effective on January 1 2026, assigning 0.85 relative value units to the analysis and 4.00 RVUs for physicians performing the service.
The nationwide endorsement removes a critical reimbursement barrier and expands HeartFlow’s addressable market to the majority of insured lives in the United States. It follows similar decisions by Humana, Cigna, and UnitedHealthcare, underscoring a growing trend of payer acceptance for AI‑driven cardiovascular diagnostics. By securing reimbursement from a major insurer, HeartFlow positions itself to accelerate adoption of its Plaque Analysis platform and strengthen its competitive moat in the non‑invasive CAD diagnostics space.
HeartFlow’s Q3 2025 results provide context for the coverage expansion. Total revenue rose 41% year‑over‑year to $46.3 million, driven by increased case volume and production efficiency. The company guided full‑year 2025 revenue to $173.0 million–$173.5 million, a 37.5%–38.0% growth projection that exceeds analyst expectations. Gross margin improved to 76.5% from 75.7% in the prior year, reflecting higher mix of high‑margin services and operational leverage. Despite a net operating loss of $15.1 million, HeartFlow’s cash position remains strong at $291.2 million as of September 30 2025.
John Farquhar, President and CEO of HeartFlow, described Aetna’s decision as a “pivotal step in expanding access to our AI‑driven plaque quantification and characterization technology.” He added that the coverage, combined with the new CPT code, will enable more clinicians to incorporate Plaque Analysis into routine care, potentially accelerating the company’s revenue trajectory.
The announcement was well received by investors, with analysts noting the coverage expansion as a key driver for future revenue growth. The move reinforces HeartFlow’s market leadership and signals confidence in the scalability of its AI platform.
In summary, Aetna’s nationwide coverage of HeartFlow’s Plaque Analysis platform represents a strategic win that removes a major reimbursement hurdle, expands the company’s market reach, and supports the growth trajectory outlined in its recent earnings guidance.
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