What You Should Know
- The Reimbursement Milestone: Effective April 1, 2026, the Centers for Medicare and Medicaid Services (CMS) has established a new national billing code and payment pathway under the Hospital Outpatient Prospective Payment System (OPPS) for the algorithmic analysis of coronary artery calcium (CAC) and aortic valve calcium (AVC) on chest CT scans.
- The FDA Clearance: In tandem with the CMS news, Bunkerhill Health received FDA clearance for Bunkerhill Contrast CAC and Bunkerhill Contrast AVC. These are the first and only AI algorithms cleared to detect and quantify calcium on contrast-enhanced, routine non-gated chest CT scans.
- The Agentic Workflow: The algorithms live within Carebricks, Bunkerhill’s agentic AI platform. When the AI detects dangerous calcium levels, Carebricks allows the health system to deploy “AI agents” to automatically initiate cardiology referrals, coordinate follow-up care, and message providers.
Expanding Diagnostic Capabilities via FDA Clearance
In tandem with the reimbursement milestone, Bunkerhill received FDA clearance for Bunkerhill Contrast CAC and Bunkerhill Contrast AVC. These represent the first and only AI algorithms cleared to detect and quantify calcium on contrast-enhanced, routine non-gated chest CT scans.
This clearance significantly expands the utility of imaging that patients already receive. Previously, automated calcium quantification was largely limited to non-contrast scans; now, clinicians can capture these highly actionable findings from routine studies performed at scale for a wide range of clinical indications.
A New National Reimbursement Pathway
Bunkerhill led the submission to CMS through the New Technology APC pathway, engaging directly with the agency to define a framework for AI-enabled cardiovascular analysis.
“Establishing a reimbursement pathway is an important step toward broader adoption of AI in clinical care,” said Nishith Khandwala, co-founder and CEO of Bunkerhill Health. The new framework provides health systems with the financial clarity needed to incorporate AI-driven insights into their standard clinical workflows.
From Insights to Action: The Carebricks Platform
The new algorithms are deployed via Carebricks, Bunkerhill’s “system of action.” This AI platform allows health systems to build and deploy AI agents that do more than just analyze images:
- Holistic Reasoning: Agents use Large Language Models (LLMs) and FDA-cleared algorithms to reason across a patient’s entire medical history.
- Real-World Execution: Beyond detection, these agents can trigger referrals, coordinate follow-up care, send notifications to providers and patients, and place medical orders.
- Rapid Deployment: Carebricks enables clinical teams to design and test new AI-driven processes in days rather than months.
Collaborative Innovation
The algorithms were developed through a research consortium involving top-tier academic institutions, including UCSF, Emory University, and MedStar Health. This multi-institutional approach ensured that the AI was validated across diverse clinical environments, preparing it for immediate impact in health systems nationwide.
