Insurance, Medicare, and CPT 75577

Billing codes are how clinics talk to payers. They are not a promise that your plan will pay, and they are not a clinical recommendation. This page explains the codes you are most likely to see around CCTA and AI plaque analysis as of 2026. Do not over-read coverage. Talk with your clinician and your insurer. This is educational, not billing advice.

CPT 75574 — the CCTA code in our directory

CPT 75574 is the code commonly used for coronary CT angiography (heart, coronary arteries and bypass grafts when present, with contrast, including 3D postprocessing). Every facility page on CCTA Scan started as an address where clinicians billed 75574 to Medicare fee-for-service in calendar year 2024. Volume is FFS only. It excludes Medicare Advantage and commercial claims. It is not a quality score.

If your explanation of benefits shows 75574, that is the scan. Other heart CT codes exist; a calcium score is not 75574. See CCTA vs calcium score.

Medicare coverage for CCTA depends on the indication, the setting, and current Medicare rules. A 2024 paid claim at a hospital does not mean your 2026 exam is automatically covered. Prior authorization is common in commercial plans. We cannot obtain authorization for you.

CPT 75577 — AI plaque analysis (Category I as of 2026-01-01)

CPT 75577 is the Category I code path used for AI-enabled plaque analysis on a coronary CT, effective January 1, 2026. It is not the CCTA itself. It is an add-on interpretation layer after pictures exist.

Public discussion of 75577 (and of Medicare’s handling of it) has generally tied the service to an indicated CCTA with CAD-RADS 1–3 (plaque present, not the most severe obstructive categories). That is a coverage shape, not a guarantee. Medicare may require that the CCTA already be payable, that the plaque software be used in that intermediate range, and that documentation support it. Commercial payers write their own policies and may lag, deny, or bundle the service.

We do not claim that Medicare or any insurer will pay 75577 for you. We do not claim that a listed hospital offers the software. On every seed listing, AI plaque is Unknown — not “no,” and not a vendor badge (Cleerly, HeartFlow, Elucid, or anyone else).

FFR-CT is another add-on

Fractional flow reserve derived from CT (FFR-CT) is a separate analysis some centers buy from a vendor. It has had its own coding and coverage history, distinct from 75577. Our listings show FFR-CT as Unknown unless a center claims the page. We will not invent that a site “has HeartFlow.”

What patients can do, practically

• Ask the ordering office which codes they expect to submit (75574, and whether anything else)
• Ask your plan whether CCTA needs prior authorization and what clinical notes they want
• If someone mentions “AI plaque” or 75577, ask: Is this required for my care? What is my cost if the plan denies it? What CAD-RADS range are they assuming?
• Get a self-pay estimate in writing if you are uninsured — our cash price field is Unknown on seed rows
• Do not treat a directory volume number as in-network status

How this site stays conservative

We would rather leave a field Unknown than publish a phone number, a cash price, a coverage promise, or a vendor logo we did not verify. Claim a listing if you run a center and want those fields filled in.

For the test itself, read What is a CCTA?. For locations, use Find a CCTA or city pages such as Los Angeles and Sacramento. Most CCTA exams still need a physician order.

This article is educational and is not medical, billing, or insurance advice. Rules change. Confirm with your plan and your doctor.