Appendix E - National Coverage Determinations Manual / Cardiac Rehabilitation Programs

Why This Topic Matters

Coverage policy for cardiac rehabilitation affects patient eligibility, documentation, service planning, and reimbursement under Medicare. Understanding the scope of this NCD helps organizations align program operations with federal coverage guidance.

Article Sections

1. A. General

   Introduces the cardiac rehabilitation program framework and the general characteristics of Phase II rehabilitation services.

2. B. Nationally Covered Indications

   Summarizes the beneficiary categories addressed by the Medicare coverage determination and the core program requirements that apply to covered services.

3. 1. Program Requirements

   Outlines the operational expectations for covered cardiac rehabilitation services, including length of service, program components, facility capabilities, and staffing oversight.

4. C. Nationally Non-Covered Indications

   States the general exclusion language for indications not addressed as covered under the policy.

5. D. Other

   Addresses discretionary coverage beyond the standard service period and the overall session limits described in the determination.