CMS Pub. 100-03, ch. 1, § 20.31

Intensive cardiac rehabilitation (ICR) refers to a physician-supervised program that

furnishes cardiac rehabilitation services more frequently and often in a more rigorous

manner. As required by §1861(eee)(4)(A) of the Social Security Act (the Act), an ICR

program must show, in peer-reviewed published research, that it accomplished one or

more of the following for its patients: (1) positively affected the progression of coronary

heart disease; (2) reduced the need for coronary bypass surgery; and, (3) reduced the need

for percutaneous coronary interventions. The ICR program must also demonstrate

through peer-reviewed published research that it accomplished a statistically significant

reduction in five or more of the following measures for patients from their levels before

cardiac rehabilitation services to after cardiac rehabilitation services: (1) low density

lipoprotein; (2) triglycerides; (3) body mass index; (4) systolic blood pressure; (5)

diastolic blood pressure; and, (6) the need for cholesterol, blood pressure, and diabetes

medications. Individual ICR programs must be approved through the national coverage

determination process to ensure that they demonstrate these accomplishments.