CMS Pub. 100-08, ch. 10, § 10.2.2.5

ICR suppliers are a supplier type that enrolls via the Form CMS-855B.

A. Background

Under 42 CFR § 410.49(a), an intensive cardiac rehabilitation (ICR) program is defined as a

physician or non-physician practitioner-supervised program that furnishes cardiac rehabilitation

and has shown, in peer-reviewed published research, that it improves patients' cardiovascular

disease through specific outcome measurements described in § 410.49(c). (Nonphysician

practitioners are eligible to supervise an ICR effective January 1, 2024.)

ICR programs must be approved by CMS through the national coverage determination

(NCD) process and must meet certain criteria for approval. Individual sites seeking to

provide ICR services via an approved ICR program must enroll with their local Medicare

contractor as an ICR program supplier.

B. ICR Enrollment

To enroll as an ICR site, a supplier must complete a Form CMS-855B with the supplier

type of “Intensive Cardiac Rehabilitation” selected. The contractor shall verify that CMS

has approved the ICR program through the NCD process. A list of approved ICR programs

will be identified through the NCD listings, the CMS Web site, and the Federal Register.

The contractor shall use one of these options to verify that the ICR program has met CMS

approval.

An ICR supplier must separately and individually enroll each of its practice locations. The

supplier can therefore only have one practice location (which shall receive its own Provider

Transaction Access Number (PTAN)) on its Form CMS-855B enrollment application. The

contractor shall use specialty code 31 for these enrollments.

The contractor may accept and process reassignments to ICRs from physicians and

nonphysicians who are otherwise authorized to reassign benefits under existing law and

policy.

It is important that the contractor review and adhere to the following regulations and

instructions regarding the required qualifications of ICR suppliers:

• 42 CFR § 410.49

• Pub. 100-04, chapter 32, sections 140.2.2 - 140.2.2.6

• Pub. 100-02, chapter 15, section 232