Qualifying Diagnoses for CR & PR: CMS Qualifications
** Always Check with your insurance for pre-approval of service - some insurances may cover events/procedures not listed here **
Cardiac Rehab:
- MI (STEMI or N-STEMI) - within 12 months of event
- Valve Surgeries (repair or replacement)
- CABG
- Percutaneous Transluminal Coronary Angioplasty (PTCA)
- PCI - Coronary Stent Placement
- Stable Angina Pectoris
- Heart/Heart-Lung Transplant
- Stable CHF with Reduced EF - Class II to IV despite optimal medical management, EF 35% or less
Pulmonary Rehab:
** Medicare Part B covers PR for individuals who meet the following criteria **
- COPD
- Other Chronic Lung Diseases that significantly impair breathing
- Post-Covid (symptoms for at least 4 weeks after confirmed os suspected COVID-19)
- Moderate to Severe Chronic Lung Disease that affects daily activities (Non-COPD/Other Respiratory Ailments covered for Respiratory Therapy Services