Does Medicare Cover Cardiac Rehab? Eligibility & Costs

Cardiac rehabilitation is a supervised program to improve cardiovascular health after a heart event or procedure. It includes exercise training, education on heart-healthy living, and counseling for overall well-being. Medicare Part B generally covers these programs for eligible beneficiaries for recovery and risk factor reduction.

Medicare Eligibility for Cardiac Rehabilitation

Medicare Part B covers cardiac rehabilitation programs with a physician’s referral and if specific medical conditions are met.

• A heart attack within the past 12 months
• Coronary artery bypass surgery
• Current stable angina pectoris
• Heart valve repair or replacement
• A percutaneous coronary intervention (angioplasty or stent placement)
• A heart or heart-lung transplant
• Stable chronic heart failure with specific diagnostic criteria

A physician’s referral is a requirement for Medicare to cover these services, confirming medical necessity. Standard cardiac rehabilitation programs typically cover up to 36 sessions, each lasting approximately one hour, over a period of 36 weeks. If medically necessary, Medicare may approve an additional 36 sessions for extended rehabilitation. For intensive cardiac rehabilitation programs, up to 72 sessions may be covered over an 18-week period, if prescribed by a physician.

Covered Cardiac Rehabilitation Services

A Medicare-covered cardiac rehabilitation program includes a range of services to support recovery and promote cardiovascular health. Physician-prescribed exercise, tailored to individual needs and supervised by healthcare professionals, is a core component. This training often involves continuous monitoring of heart rate and rhythm for safety and effectiveness.

Programs also incorporate cardiac risk factor modification, including education, counseling, and behavioral intervention. This focuses on nutrition, medication management, and strategies to reduce risk factors like high cholesterol or blood pressure. Psychosocial assessment and counseling are also provided to address stress, anxiety, and depression often associated with heart disease.

Each participant receives an individualized treatment plan, established and reviewed regularly by a physician. These comprehensive services are provided in a hospital outpatient setting or in a physician’s office, ensuring access to necessary equipment and immediate medical availability.

Your Financial Responsibility

While Medicare Part B covers a substantial portion of cardiac rehabilitation costs, beneficiaries are responsible for certain out-of-pocket expenses. The annual Part B deductible must be met before Medicare pays. For example, the 2025 Part B deductible is $257.

After the deductible is satisfied, beneficiaries typically pay 20% of the Medicare-approved amount for services. This coinsurance applies to services in a physician’s office. In a hospital outpatient department, a copayment may also be required in addition to coinsurance.

Additional insurance, like Medigap (Medicare Supplement Insurance) policies, can help cover the 20% coinsurance and deductibles. Medicare Advantage (Part C) plans also cover cardiac rehabilitation. While they must offer at least the same coverage as Original Medicare, their specific cost-sharing rules, such as deductibles, coinsurance, or copayments, may differ.

How to Get Started with Cardiac Rehabilitation

To start Medicare-covered cardiac rehabilitation, discuss it with your treating physician. Your doctor, such as your cardiologist or primary care physician, will assess your medical history and current health to determine if cardiac rehabilitation is appropriate and if you meet eligibility criteria.

If suitable, your physician will provide the necessary referral or order for enrollment. Find a Medicare-approved program by asking your doctor or contacting local hospitals and medical centers. Many facilities have staff to guide enrollment.

Upon referral, the rehabilitation team conducts an initial assessment to create a personalized treatment plan. After this assessment, you will begin scheduled sessions, working with healthcare professionals to progress through your program.