Cleerly vs Elucid
The two American plaque quantification rivals are benchmarked against each other in the peer reviewed literature, so the buying question is what each grounds its numbers in and how each gets paid. Cleerly is the incumbent with the payment machinery: cleared in 2020, its analysis underpins Category I CPT codes, Medicare contractor coverage, and commercial policies reported to span more than 86 million covered lives, with the multicenter CONFIRM2 registry behind it. Elucid's PlaqueIQ, cleared in October 2024, is distinguished by its ground truth: the networks were trained on carotid endarterectomy histopathology co registered to CTA, classifying plaque against actual tissue rather than Hounsfield unit thresholds, which matters because attenuation values overlap between tissue types like lipid rich necrotic core and intraplaque hemorrhage. Its coverage is real too: four of seven Medicare contractors from late 2024 and United Healthcare alignment from October 2025. Two cautions: Elucid's workflow is not fully autonomous, trained analysts segment the data before the software classifies, and its FFRCT product remains pending clearance and is not available. If your failure mode is coverage breadth today, start with Cleerly. If your failure mode is confidence in what the plaque composition numbers mean, start with Elucid.
- Coverage breadth today: Category I CPT underpinning, multiple Medicare Administrative Contractor determinations, and commercial payer policies reported at more than 86 million covered lives.
- First mover tenure: cleared in 2020, the longest run in this competitive set, with the multicenter international CONFIRM2 registry in the evidence base.
- Benchmarked willingly: Cleerly appears among the eight systems compared head to head in the Nature Reviews Cardiology QCI consensus statement.
- Ground truth is your question: networks trained on carotid endarterectomy histopathology co registered to CTA, marketed as CT Virtual Histology, graded A on this index's model transparency axis.
- Lipid rich necrotic core is what you need called correctly: spatial interpretation across adjacent voxels rather than fixed Hounsfield ranges, targeting exactly the tissue overlap where thresholds fail.
- The platform is extending to stroke: a carotid version launched October 2025 applies the same histology grounded approach to carotid disease, with Medicare contractor and United Healthcare coverage already in place for the coronary product.
Side-by-Side
| Axis | C Cleerly |
E Elucid |
|---|---|---|
| AI Centrality | ||
| Autonomy and Oversight Model | ||
| Model and Technology Transparency | ||
| Clinical and Operational Evidence | ||
| AI Safety and PHI Stewardship | ||
| HIPAA and BAA Posture | ||
| Security Certifications and Trust Center | ||
| FDA and Regulatory Status | ||
| AI Governance and Bias Disclosure | ||
| EHR and Interoperability Depth | ||
| Deployment Model and Data Residency | ||
| Commercial Transparency | ||
| Setting and Specialty Coverage |
Covered lives and coverage figures are vendor published. Elucid's workflow includes trained analysts who segment the data to create the coronary model before the software classifies tissue, so it is not fully autonomous, and its FFRCT product is pending FDA clearance and should not be treated as available. Elucid routes imaging to vendor side processing with analysts involved; buyers under data sovereignty constraints should establish where scans go for either product. The Category I CPT for automated plaque analysis, reported at US$950 per assessment from January 2026, is set by the payer system rather than either vendor.