Original Medicare (Parts A & B): Cardiac Rehabilitation Services (Cardiac Rehab)

Cardiac rehab is a physician-supervised program designed to improve cardiovascular health following a major cardiac event or existing chronic cardiac condition. It is defined by the World Health Organization (WHO) as “The sum of activity and interventions required to ensure the best possible physical, mental, and social conditions so that patients with chronic or post-acute cardiovascular disease may, by their own efforts, preserve or resume their proper place in society and lead an active life.”

Comprehensive cardiac rehab programs and services include exercise, education, and counseling.  Intensive cardiac rehab programs contain the same elements as traditional cardiac rehab programs but are typically more rigorous or more intense.  These services are covered when administered in a physician’s office or hospital outpatient setting.  Some cardiac rehab is moving into the community and even home-based settings.

There are three defined phases to cardiac rehab: the clinical phase (1), outpatient cardiac rehab (2), and post-cardiac rehab (3).

Phase 1 begins in the inpatient setting soon after a cardiovascular event or completion of a cardiovascular intervention and includes assessment, education, physical therapy, and discharge planning.  There is usually a 3-6 week recovery period between Phase 1 and Phase 2, where healing and Phase 1 learning reinforcement occur (prior to cardiology clearing the patient for Phase 2).

Phase 2 occurs once a patient is stable and cleared by cardiology to begin outpatient cardiac rehab, where the exercise, education, and counseling begin.  Cardiac rehab is typically scheduled 2-3 days per week for about 3 months but can range anywhere from 2 to 8 months.  Attendance determines how long it will take to finish the program.  Those who attend regularly, as scheduled, tend to complete the program sooner.

Phase 3 is achieved when Phase 2 is successfully completed and involves more independence and self-monitoring, focused on increasing flexibility, strength, and aerobic conditioning.

Those who qualify for cardiac rehab:

• Heart attack within the last 12 months

• Coronary artery bypass surgery (CABG)

• Current stable angina

• Heart valve repair or replacement

• Coronary angioplasty or stent

• Heart or heart-lung transplant

• Stable chronic heart failure (HF or CHF)

Cardiac rehab is significantly underutilized, despite strong evidence that it supports immediate and long-term target health behaviors and lifestyle changes, producing higher quality of life outcomes.