Pulmonary Rehabilitation: Coverage and Documentation Requirements

Pulmonary rehabilitation may be covered under Medicare Part B (“Part B of A”) for dates of service on or after January 1, 2010. Coverage was established in Section 144(fff)(1)) of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), and CMS declined to establish a National Coverage Determination (NCD) for pulmonary rehabilitation services. The Centers for Medicare & Medicare Services (CMS) published MLN Matters article MM6823, “Pulmonary Rehabilitation (PR) Services,” which further describes the guidelines associated with coverage of pulmonary rehabilitation under Medicare.

Cahaba Government Services has published an article to provide the criteria for coverage and the documentation required to meet the conditions of coverage. While this article is published by Cahaba Government Services, the criteria for coverage and the documentation required to meet the conditions of coverage apply to all providers and all Medicare contractors. To read the article and also obtain the CMS references for pulmonary rehabilitation, click