By CleerlyLearning Objectives
- Understand what Cleerly measures from coronary CT and why it matters
- Distinguish Cleerly's plaque-characterization approach from HeartFlow's blood-flow analysis
- Evaluate the significance of the 2026 reimbursement milestone
What Is Cleerly?
Cleerly is a cardiovascular-AI company that analyzes coronary CT angiography scans to quantify and characterize atherosclerotic plaque — the buildup in the heart's arteries that causes most heart attacks. Its approach, AI-guided quantitative CT, measures how much plaque a patient has and what type it is — for example, distinguishing higher-risk non-calcified plaque from stable calcified plaque. The goal is to move heart-disease assessment away from indirect risk scores and toward a direct, image-based picture of the disease actually present in a given patient's arteries.
Cleerly is distinct from catalogued HeartFlow, and the contrast is worth understanding. HeartFlow's flagship analysis models blood flow (a computed measure of whether a narrowing is functionally significant), while Cleerly focuses on characterizing the plaque itself. In 2026 Cleerly reached an important commercial milestone: a Category I CPT code effective January 2026, along with coverage from Medicare and major commercial payers. A dedicated reimbursement code is a strong signal that AI plaque analysis is moving from novel technology into mainstream cardiology practice — historically the point at which adoption accelerates.
💡Key Concept
Direct disease measurement: Traditional risk scores estimate heart-attack risk from indirect factors (age, cholesterol, blood pressure). Cleerly instead measures the plaque in a patient's own arteries from a CT scan — a shift from estimating risk to observing disease.
📝Note
Cleerly versus HeartFlow: Both analyze coronary CT, but they measure different things. HeartFlow computes blood flow to judge whether a narrowing limits flow; Cleerly quantifies and characterizes the plaque itself. They can be complementary views of the same disease.
✅Tip
Visit Cleerly: cleerlyhealth.com — used by cardiology practices and health systems.
Pricing
Cleerly is billed as a clinical service tied to coronary-CT analysis. The January 2026 Category I CPT code and payer coverage mean the analysis is increasingly reimbursed through standard medical billing rather than sold as software.
- AI-guided plaque quantification
- Medicare and commercial coverage
- Effective January 2026
- Integration with cardiology workflow
- Reporting and analytics
- Enterprise agreement
Core Features
Plaque Quantification
Measures the total burden of atherosclerotic plaque from a coronary CT scan, turning a qualitative read into a quantified assessment.
Plaque Characterization
Distinguishes plaque types — including higher-risk non-calcified plaque — to give a more nuanced picture of risk than a single narrowing percentage.
Direct Disease Assessment
Provides an image-based view of the coronary disease actually present, complementing or challenging indirect risk scores.
Reimbursed Clinical Pathway
With a Category I CPT code and payer coverage from January 2026, the analysis fits into standard clinical billing, easing adoption in routine cardiology.
Strengths
- Direct, quantified plaque measurement — observes disease rather than estimating risk
- Plaque characterization — flags higher-risk non-calcified plaque, not just narrowing
- Reimbursement milestone — Category I CPT code and payer coverage from January 2026
- Distinct from flow analysis — a complementary view to HeartFlow's approach
- Mainstreaming signal — moving from novel technology toward routine practice
Limitations and Considerations
- Requires a coronary CT scan — value depends on appropriate imaging being done
- Clinical impact depends on action — measurement matters only if it changes management
- Adoption still building — reimbursement is new and practice patterns are evolving
- One view of the disease — plaque characterization complements, not replaces, other assessments
- Interpretation in context — results inform, but do not dictate, cardiology decisions
Best Use Cases
| Use Case | Why Cleerly Fits | Caveat |
|---|---|---|
| Characterizing coronary disease | Quantifies and types arterial plaque | Requires a coronary CT scan |
| Refining heart-attack risk | Direct image-based assessment vs indirect scores | Value depends on changing management |
| Cardiology practices adopting AI-QCT | Reimbursed pathway from January 2026 | Adoption patterns still forming |
| Complementing flow analysis | Plaque view alongside HeartFlow's flow view | Two complementary measurements |
Key Takeaways
- Cleerly analyzes coronary CT angiography to quantify and characterize atherosclerotic plaque using AI-guided quantitative CT
- It measures the disease directly from imaging, shifting from indirect risk scores toward an image-based picture of a patient's arteries
- It is distinct from HeartFlow: Cleerly characterizes the plaque itself, while HeartFlow models blood flow — often complementary
- A Category I CPT code effective January 2026, with Medicare and commercial coverage, signals movement into mainstream cardiology
- Its clinical value depends on the assessment actually changing patient management; adoption is still building
