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Cardiac Rehabilitation

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.