CMS Recognizes Eko Health’s AI-Powered Heart Disease Detection in OPPS July 2025 Update, Establishing Payment Rate for SENSORA®

Eko Health, a pioneer in AI-powered cardiac and pulmonary care, has announced a significant milestone in its mission to revolutionize heart disease detection. The Centers for Medicare & Medicaid Services (CMS) has formally recognized Eko’s SENSORA® platform in its July 2025 provisional update to the Hospital Outpatient Prospective Payment System (OPPS), establishing a clear payment pathway for this innovative AI technology.

This pivotal decision assigns SENSORA’s Category III CPT code to Ambulatory Payment Classification (APC) 5734, with a reimbursement rate of $128.90 per use. This recognition by CMS is a powerful endorsement of the clinical value of AI-enabled cardiac disease detection, signaling federal support for its broader integration into routine healthcare.

SENSORA®, designed for effortless incorporation into existing clinical workflows, leverages AI to analyze heart sounds and electrocardiogram (ECG) data captured by Eko’s digital stethoscopes. It aids clinicians in quickly and accurately identifying signs of serious cardiovascular conditions such as structural murmurs, low ejection fraction (a key indicator of heart failure), and atrial fibrillation. The platform offers a scalable, point-of-care solution, aiming to improve early detection and bridge gaps in access to specialized cardiac evaluation.

The formal activation of SENSORA’s Category III CPT code, issued by the American Medical Association (AMA), also takes effect on July 1, 2025, further solidifying institutional acknowledgment of the utility of algorithmic cardiac support tools.

Connor Landgraf, Co-founder and CEO of Eko Health, emphasized the importance of this development: “This CPT code signals the growing importance of AI in point-of-care detection. It’s crucial to create payment models that compensate front-line providers for the additional time they spend caring for complex cardiac patients. To beat our heart disease epidemic, it’s absolutely essential for front-line providers to be empowered with advanced tools like SENSORA to identify cardiovascular disease earlier and more accurately.”

With this established payment rate, hospitals and health systems now have a clear financial incentive to adopt SENSORA, enabling earlier intervention and potentially shifting care from late-stage hospitalization to proactive, outpatient management for millions of patients. Eko Health is committed to collaborating with commercial payers, health systems, and public health agencies to expand reimbursement and accelerate widespread clinical adoption of this transformative technology.