Cardiology has been shifting to the outpatient setting for years — a transition recently accelerated by technology and payer incentive alignment toward ASCs.
In its 2026 final rule published Nov. 21, CMS approved four cardiovascular codes for electrophysiology studies and ablations and three codes for percutaneous coronary intervention, in addition to hundreds of other procedures added to the Covered Procedures List for ACSs.
Richard Chazal, MD, medical director of heart health at the Fort Myers, Fla.-based Lee Heart Institute, recently joined Becker’s to discuss the trends and procedures he sees shaping outpatient cardiology in the years ahead.
Editor’s note: This response has been lightly edited for clarity and length.
Question: How is the shift to outpatient shaping cardiology care, and what do you see developing in this space?
Dr. Richard Chazal: We’re seeing a move toward utilizing electrophysiology procedures, including ablation and insertion of some devices, in freestanding centers. Some of these procedures have matured to the point where many of these can, and perhaps should be, done in these lower-cost, efficient outpatient centers that can provide really good care.
What’s on the horizon is the emergence of less invasive procedures for valves. In the United States and worldwide, putting in heart valves in a less invasive manner, for example, the TAVR valves, where an aortic valve is inserted through a stick in an artery, rather than having a surgeon open the chest. We now do more aortic valve replacements in that manner in the United States than surgically. TAVRs have traditionally been done in a hospital setting, usually with an overnight stay, but with better techniques and improved equipment, the length of stay is shortening. So would we see in the not-too-distant future aortic valves actually being replaced in freestanding centers.
