Elucid vs Heartflow (2026)
Heartflow is built around physiology, Elucid around plaque composition. Heartflow's FFRCT estimates which lesions limit flow, validated against invasive FFR in the prospective HeartFlowNXT study, with Plaque Analysis alongside it. Elucid's PlaqueIQ classifies plaque against histology, including lipid rich necrotic core, on coronary and carotid CT; its own fractional flow reserve product, derived from the plaque analysis, is pending FDA review. Both keep trained staff in the loop: Heartflow Case Analysts work each model, and Elucid analysts segment every study. If you need physiology now, start with Heartflow. If plaque composition and carotid coverage matter more, start with Elucid.
- Plaque composition is the question: PlaqueIQ classifies plaque components against histology, including lipid rich necrotic core.
- You read carotid CT: the carotid application launched in October 2025 under the same analysis.
- Your payers cover plaque analysis: PlaqueIQ is billed under Category I CPT 75577, with coverage from four of seven Medicare contractors.
- Physiology is the decision: FFRCT estimates the physiological significance of each lesion, validated against invasive FFR in the prospective, multicenter HeartFlowNXT study.
- You want trial evidence: the PRECISE randomized trial, the ADVANCE registry and the DECIDE registry of about 22,000 patients.
- You want the limits stated: the indications page names the populations the analysis was not evaluated in.
This comparison is published by AI Health Index, an independent research platform that compares healthcare AI vendors objectively. Elucid and Heartflow are each graded against the same capability taxonomy, from each vendor's own public materials and the regulatory record, under the AI Health Index verification standard. No vendor pays for placement, and no vendor has reviewed this page. How this evidence is graded
Plain facts
| Fact | Elucid | Heartflow |
|---|---|---|
| Primary category | Radiology & Imaging AI | Radiology & Imaging AI |
| Founded | Not recorded | 2007 |
| Headquarters | Boston, Massachusetts, United States | Mountain View, California, United States |
| Website | elucid.com | heartflow.com |
Side by Side
Select any grade to read the note behind it.
Product updates
The latest logged changes from each vendor, newest first, each linked to its source.
Heartflow
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Product / capability
Heartflow PCI Navigator entered commercial use outside of clinical trials, with The Valley Hospital becoming the first U.S. institution to deploy the software.
Source
Each vendor in one paragraph
Written to be quoted whole. Each paragraph opens the AI Health Index profile of the vendor: what the product is, who buys it and what it does.
Elucid analyzes coronary and carotid CT angiography to quantify and classify atherosclerotic plaque, including lipid rich necrotic core, the plaque type most linked to heart attack and stroke. Plaque-IQ, cleared by the FDA in September 2024 (K241524), classifies plaque components against ground-truth histology rather than fixed Hounsfield unit ranges, an approach the company calls CT Virtual Histology, and reports patient, vessel and lesion level composition, stenosis and CAD-RADS scoring; the carotid application launched in October 2025.
Source: AI Health Index, September 2026
Heartflow created non-invasive coronary physiology from CT. Its Heartflow One platform analyzes a coronary CT angiogram a hospital has already acquired: Roadmap Analysis for stenosis, FFRCT Analysis for the physiological significance of each lesion, simulated from a 3D model of the coronary arteries, Plaque Analysis and plaque staging, and PCI Navigator for planning intervention, now in routine use at The Valley Hospital.
Source: AI Health Index, September 2026
Questions buyers ask
How do Elucid and Heartflow work with the EHR?
For Elucid, the integration work a site takes on is not described either.
Heartflow describes CT studies sent securely to it without manual export and results returned into both PACS and the electronic record, with a support team that deploys the software and integrates it with PACS, record and other hospital systems. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified September 27, 2026. No vendor pays for placement.
How are Elucid and Heartflow priced and sold?
Elucid publishes the CPT codes that apply (CCTA 75574; Plaque-IQ under Category III codes 0623T to 0626T and, from January 2026, Category I 75577) and a state by state insurer coverage map, and says 70 percent of insured US lives have positive coverage policies; four of seven Medicare contractors, EviCore and UnitedHealthcare cover AI plaque analysis.
Heartflow publishes reimbursement resources and a market access value dossier. The dossier records a Category I CPT pathway for AI plaque analysis of coronary CT, CMS payment for plaque analysis as a separate outpatient hospital service, a July 2025 EviCore coverage recommendation for Plaque Analysis, and states frankly that current reimbursement does not adequately pay for FFRCT. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified September 27, 2026. No vendor pays for placement.
Which settings and specialties do Elucid and Heartflow cover?
With Elucid, the plaque classification is validated against histology, and the company markets it for a broad insured US population.
In Heartflow's case, the intended use covers adults 22 and over with suspected coronary artery disease (the combined analysis) and clinically stable symptomatic patients (FFRCT), and FFRCT's performance was validated in patients who were candidates for invasive angiography, with CT acquired within 60 days of invasive FFR. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified September 27, 2026. No vendor pays for placement.
What evidence is published for Elucid and Heartflow?
Elucid publishes correlations between Plaque-IQ and pathologist-read histology from the data behind its clearance (K241524): total plaque r = 0.99, calcified 0.95, non-calcified 0.86, and lipid rich necrotic core 0.88, without the number of specimens or patients.
With Heartflow, the company's indications page summarizes performance as 84 percent accurate, 82 percent sensitive and 85 percent specific. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified September 27, 2026. No vendor pays for placement.
Related comparisons
Other published head to head assessments involving these vendors or their closest peers. The full set for this category is on the Clinical Decision Support page.
Elucid's histology correlations are published without case counts. Heartflow's plaque and roadmap functions are cleared in the US but not in Europe, the UK, Australia, Canada or Japan. Neither vendor publishes a price.