Original Medicare (Parts A & B): Pulmonary Rehabilitation Programs (Pulmonary Rehab)

Pulmonary rehab services help people with lung disease live and breathe better, as well as improve chest strength and physical endurance.

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Cost
20% of the Medicare-approved amount if delivered in a provider's office; copay per session if delivered in an outpatient hospital setting; Part B deductible applies
Prior Authorization Required
No
Provider Referral or Order Required
Yes

How To Receive

Details on how to apply

  1. Receive a referral for pulmonary rehab from the provider treating the chronic lung disease.

  2. If pulmonary rehab will be performed in an outpatient hospital setting, ensure that it is Medicare-certified.

  3. Schedule the initial consultation for the pulmonary rehab program.

  4. Attend the appointment and schedule future sessions.

    • Typically 2-hour sessions, twice per week, for 4-12 weeks, maybe more.

  5. Attend the sessions, as scheduled, until individual goals are met.


For more information on Medicare benefits and coverage, call 1-800-MEDICARE (1-800-633-4227) or visit the Medicare Benefits Website. TTY users, call 1-877-486-2048.

Availability
As ordered by a provider

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Pulmonary rehabilitation is a supervised medical program that may be needed in the presence of lung disease such as chronic obstructive pulmonary disease (COPD). It is a program of education and exercise to increase awareness about lung function and lung disease.

Patients are monitored and taught to exercise safely by paying attention to their breathing and oxygen levels, as well as learning exercise modifications and breathing techniques that promote both lung capacity and energy conservation. People with lung disease become stronger by increasing their level of fitness, which in turn reduces shortness of breath.

Skills and knowledge learned in the program help people feel better and manage their chronic lung disease. Exercising the lungs and muscles helps people with lung disease be more active so they can do the things they enjoy with their loved ones.

Classes are offered in a group setting, providing the opportunity to meet others with the same condition and give and receive peer support.

Pulmonary rehab may even decrease the need for hospital visits.

Comprehensive programs of pulmonary rehabilitation are covered for those who have moderate to very severe chronic obstructive pulmonary disease (COPD) and receive a pulmonary rehab referral from the provider treating the chronic lung disease.

Pulmonary rehab is also covered for those with confirmed or suspected COVID-19 and who experience persistent symptoms that include respiratory dysfunction for at least 4 weeks.

Pulmonary rehab programs are generally 2-hour sessions, twice per week, for 4 to 12 weeks, maybe more.

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