Eli's Rehab Report

In CMS’ proposed rule for expanding bundled payment programs to include cardiac care, the agency also added a promising piece for cardiac rehab — which could put a nice feather in your PT reimbursement hat.

In a cardiac patient’s 90-day period after discharge, CMS proposes establishing a two-part cardiac rehab incentive payment paid retrospectively based on total cardiac rehab. The initial payment would be $25 per cardiac rehab service for the first 11 services paid for by Medicare during the care period following a heart attack or bypass surgery. After these first 11 services, the payment would increase to $175 per service.

Limits: Cardiac rehab sessions would be capped at two one-hour sessions per day for up to 36 sessions within 36 weeks. Medicare Administrative Contractors (MACs) would have to approve additional sessions. For intensive cardiac rehab, sessions would be limited to 72 one-hour sessions, up to six sessions per day over 18 weeks.