CMS Approves Unique Subspecialty Code for ACHD

Posted Tuesday, Apr 07, 2020

Last month, the Centers for Medicare and Medicaid Services (CMS) approved "Adult Congenital Heart Disease Specialists" as a unique subspecialty and designated an ACHD subspecialty code. This is a critical step to ACHD program building and improving access around the country to high-quality ACHD care. The unique distinction for ACHD allows ACHD cardiologists to be recognized by CMS—and hence other insurance companies—as a distinct subspecialty and different from general (adult) cardiology and pediatric cardiology. Without this distinct code, ACHD cardiologists are evaluated and measured the same as general cardiologists and therefore outcome data and quality metrics and measures do not fully represent the patient population or the field of ACHD.

The American College of Cardiology submitted the application with the support of ACHA. We thank longtime ACHA Medical Advisory Board member and immediate past chair Curt Daniels, MD, FACC, Director of the COACH (Columbus Ohio Adult Congenital Heart Disease & Pulmonary Hypertension) Program for leading this effort. We would also like to acknowledge the following for assisting with data collection that was vital to gaining approval: Elisa Bradley, MD, from The Ohio State University and the COACH Program; Alexander (Sasha) Opotowsky, MD, MPH, MMSc, from the Adult Congenital Heart Disease Program at Cincinnati Children’s Hospital Medical Center; Michelle Gurvitz, MD, from Children's Hospital Boston/Brigham and Women's Hospital, and the Boston Adult Congenital Heart Program (BACH).