US · guidance
CMS Pub. 100-04, ch. 32, § 140.1
CR Program Services Furnished On or Before December 31, 2009
Medicare covers CR exercise programs for patients who meet the following criteria:
• Have a documented diagnosis of acute myocardial infarction (MI) within the preceding 12
months; or
• Have had coronary bypass surgery; or,
• Have stable angina pectoris; or,
• Have had heart valve repair/replacement; or,
• Have had percutaneous transluminal coronary angioplasty (PTCA) or coronary
stenting; or,
• Have had a heart or heart-lung transplant.
Effective for dates of services on or after March 22, 2006, services provided in connection with a CR exercise
program may be considered reasonable and necessary for up to 36 sessions. Patients generally receive 2 to 3
sessions per week for 12 to 18 weeks. The contractor has discretion to cover CR beyond 18 weeks. Coverage
must not exceed a total of 72 sessions for 36 weeks.
CR programs shall be performed incident to physician’s services in outpatient hospitals, or outpatient settings
such as clinics or offices. Follow the policies for services incident to the services of a physician as they apply in
each setting. For example, see Pub. 100-02, Chapter 6, §2.4.1, and Pub. 100-02, Chapter 15, §60.1. (Refer to
Publication 100-03, §20.10 for further coverage guidelines.)
History
(Rev. 11426; Issued: 05-20-22; Effective: 01-01-22; Implementation: 07-05-22)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
1fe86f3f2f4beb9bfee545681cde8c933763d2a222dc4d3c118f38e46e8a484c
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