Cardiac rehabilitation may be covered for hospital-based acute rehabilitation, including inpatient hospitalization and up to 36 outpatient sessions per cardiac event.
One of the following events must have occurred in the preceding 12 months:
- myocardial infarction
- coronary artery bypass graft
- coronary angioplasty
- percutaneous transluminal coronary angioplasty
- chronic stable angina (limited to 36 sessions in a calendar year)
- heart valve surgery
- heart transplants, to include heart-lung
- congestive heart failure (CHF) or stable chronic heart failure (SCHF) (limited to 36 sessions in a calendar year)
If covered, the setting where the services are provided will determine cost; outpatient office setting or inpatient hospital setting.
Non-hospital based cardiac rehabilitation programs and Phase III cardiac rehabilitation for lifetime maintenance performed at home or in medically unsupervised settings are not covered benefits.