AI has begun to play an important role in aiding physicists in diagnostics — and the Centers for Medicare & Medicaid Services has recognized this progress in recent years by granting dedicated reimbursement codes and payments to a handful of diagnostic AI tools that demonstrate clear clinical utility, such as those for detecting diabetic retinopathy, analyze coronary artery disease and triaging stroke patients.
This week, CMS established payment rates for another AI-powered diagnostic tool. The agency has established a payment rate of $128.90 per use for Eko Health’s Sensora platform, which is designed to help clinicians diagnose heart disease.
California-based EKO Health was founded in 2013 to help clinicians and their digital stethoscopes and accompanying AI platforms get rid of traditional ways of reactive disease detection. The platform combines stethoscope data with real-time ECG data to mark severe cardiac fibrosis such as atrial fibrillation, low ejaculation scores, and valve heart disease.
CEO Connor Landgraf said that by placing EKO’s AI system payment rates, CMS is implementing cardiac screening for providers at points of care.
“Cardiovascular disease remains the leading cause of death in the United States, but many serious diseases, including low ejaculation fraction, valve heart disease, and atrial fibrillation, are not detected during routine examinations. Primary care clinicians often lack time, tools, or professional training to capture these early warnings, especially in the context of fast-paced surgical services,” he explained. ”
As a result, delayed diagnosis is too common. Landgraf said patients often have no diagnosis until symptoms become severe, which means higher costs, poorer outcomes and preventable hospitalization.
He added that this diagnostic gap not only puts pressure on the health care system — but also disproportionately harms patients facing barriers to professional care.
EKO’s AI platform is designed to address this challenge by providing frontline clinicians with real-time clinical decision support for routine physical examinations. For Landgraf, the system “turns standard doctor’s exams into advanced cardiac examinations without adding additional time or complexity.”
Eko’s digital auditory instrument allows clinicians to listen to the patient’s heart as usual. When they did this, the stethoscope recorded the sound and rhythm of the patient’s heart and immediately sent the data to EKO’s AI platform for analysis. Landraf said that in less than a minute, the system checks for signs of heart problems and shows an alarm for errors.
The platform is trained on data of millions of heart sounds and rhythms, which is why it can choose patterns that are too subtle or complex for human clinicians to recognize.
“By converting standard stethoscopes into smart diagnostic tools, Sensora allows scalable early detection at the point of care,” Landgraf declares.
The goal is to help get heart disease early when it is easier to treat and make high-quality diagnostic care more accessible.
In Landgraf’s eyes, CMS’s EKO system reimbursement framework provides health systems and hospitals with greater confidence in investing in innovative technologies.
“It supports a more equitable care model by bringing advanced cardiac insights into settings that may not have immediate access to the expert or diagnostic equipment. This approach strengthens broader goals in healthcare, including the expansion of preventive care, reduced disparity, and advances in sustainable innovation throughout the system.
EKO sold more than 650,000 digital stethoscopes, all of which were able to connect with its AI software.
Photo: Ismagilov, Getty Images
