Cardiac Rehab Job Postings
EP: Full-time Banner Boswell: Careers (myworkdayjobs.com)
RN: Full-time HonorHealth John C. Lincoln
Please note: There is no guarantee that job postings are still available when you read this. It is your responsibility to do a job search with the organization listed.
Pulmonary Rehab/Respiratory Services Billing Updates
Please see the attached Presentation made by our State Representative Holly Bright. This regards changes to Pulmonary Rehab/ Respiratory Services Billing Codes as well as PR coverage for post-COVID-19 patients.
For further resources, please review 2022 Medicare Regulations from the AACVPR website.
Take Action Now!
Take Action: Tell your Legislators to Support SOS: Sustaining Outpatient Services Act
Your federal legislators need to hear this message directly from you, so that they will join in support of the bill. To contact your lawmakers, simply fill out your information below, and you will be connected directly to your US Representative and US Senators with a pre-loaded message to send.
We will be contacting each of the legislative and senate offices by MARCH 1. If you could please have your letter and/or phone completed by then it will increase our effectiveness in accomplishing our goals.
Click on the button to the right to fill in the online letter to your legislator!
US House bill # HR 3348, SOS: Sustaining Outpatient Services Act: This bill will exempt certain hospital outpatient services, including cardiac, intensive cardiac, and pulmonary rehabilitation (CR, ICR, PR) from a drastic reimbursement reduction that is based solely on the location of the hospital outpatient service. The Sustaining Outpatient Services Act mandates that Medicare payment for hospital-based CR/ICR/PR services remain under the outpatient payment rate. The 40% reduction in reimbursement for off-campus CR/ICR/PR is unsustainable, and yet, these services are underutilized and are encouraged to expand to treat more beneficiaries than is physically possible. This legislative correction will remove the financial barrier to expanded patient access to these beneficial services.
US House bill # HR 1956, Increasing Access to Cardiac Rehabilitation Care Act of 2022: This bill simply moves up the effective date of when nonphysician practitioners (NPPs or APPs) are eligible to independently order and supervise cardiac, intensive cardiac, and pulmonary rehabilitation services. The effective date is currently January 1, 2024. This bill, if passed, will move that effective date up to 2022.
Obviously, HR 3348 and HR 1956 are synergistic. Programs are currently at capacity with excessively long waiting lists to even begin CR, ICR, or PR. With this bill, cardiopulmonary rehabilitation services will be able to improve access and meet the increasing demand for these beneficial treatments.
Take Steps to Advocate!
Contact Your U.S. Representatives with a Customizable Letter
Want to help? It’s not too late to join fellow practitioners in your state to advocate for CR, ICR, and PR services. Please ask for support (i.e., signature on both bills) of HR 3348 and HR 1956. AACVPR has made it easy. Anyone, including rehab staff members, physicians, hospital administrators, and grateful patients can be an advocate for CR and PR services. Use the below pre-drafted, customizable letters to contact your U.S. House representative and advocate for bills above. Just 5 minutes and one letter could make a huge difference! Show your support for the life-changing effects of CR/ICR/PR and click on one of the buttons below to start your letter.
Converse With Your U.S. Representatives Over the Phone
A brief phone call to your US Representative’s DC office is also very powerful to express your support for HR 3348 and HR 1956.
It is a very simple message:
- Share your name, where you live and where you work
- Ask for support of these two bills
- HR 3348 to allow adequate reimbursement for ALL cardiac and pulmonary rehab programs, whether on or off campus
- HR 1956 to increase access to cardiac and pulmonary rehab programs by allowing non-physician practitioners to order and supervise these services.
- Explain why both bills are important to you
- HR 1956 increases access to medically directed, life-saving cardiac and pulmonary rehabilitation programs by reducing delay to enrollment and allowing professional practitioners to order and supervise these services. The Access to Quality Cardiac Rehabilitation Care Act simply moves up the enactment date from 2024 so people can get started with the life-saving treatment they need now.
- HR3348 will allow program locations that are more accessible to patients and offer larger capacity to provide these services to more patients
Returning with Care Resources from AACVPR
As shelter-at-home laws are relaxed, the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) offers general considerations for cardiac and pulmonary rehabilitation (CR/PR) programs as they determine when and how to safely resume center-based rehabilitation and keep patients and staff safe using COVID-19 safety protocols.
6/4/2020 Health Policy & Reimbursement Update from AACVPR
Disruption of Rehabilitation Services
Cardiac, pulmonary, and supervised exercise therapy (SET) programs were abruptly interrupted by the public health emergency (PHE). Many AACVPR members have asked if Medicare beneficiaries will be able to resume their course once programs are able to re-open if the time limit for those services has passed in the interim. AACVPR asked this of CMS last week and received the following information.
Traditional CR (Cardiac Rehabilitation) allows for MAC (Medicare Administrative Contractor) discretion for additional sessions over an extended period of time past the initial coverage allowance of up to 36 sessions over up to 36 weeks. SET (Supervised Exercise Therapy for PAD) also allows for MAC discretion for additional sessions beyond the 12-week window allowed for up to 36 SET sessions. CMS has stated that this allows the MACs to use their discretion to cover more sessions once patients are able to safely participate in CR or SET after this PHE (public health emergency). Claims for these services would include the KX modifier.
Because the session and time limits for ICR (Intensive Cardiac Rehabilitation), 72 sessions over up to 18 weeks, were established in statute (MIPPA), CMS has determined that this cannot be waived or paused during the PHE.
PR (Pulmonary Rehabilitation) is covered for up to 36 sessions over an undefined period of time with MAC discretion for an additional 36 sessions over an extended period of time. Once patients are able to safely resume after the PHE, the MACs would continue to have discretion for up to an additional 36 sessions. Claims for sessions after the initial 36 (sessions 37 through 72) would include the KX modifier. Once 72 sessions have been provided in a Medicare beneficiary’s “lifetime”, no further sessions are covered, despite future qualifying diagnoses.
AACVPR Requests CMS Waivers
Members have been made aware of the communication between AACVPR and partner professional organizations with CMS asking for the ability to deliver CR and PR services through the PHE. AACVPR has not yet received an answer to the second request for some mechanism to obtain reimbursement for the various means programs are using to serve our Medicare beneficiaries while programs have been closed.
CMS declined the first request for expansion of telehealth code usage by CR and PR programs because our services are primarily delivered by clinical staff in the hospital outpatient setting. Telehealth codes are available only for physicians and Qualified Health Care Practitioners (QHPs), such as NPs, PAs, CNS, licensed psychologists, etc., who directly bill Medicare under the Physician Fee Schedule (PFS) for their professional services.
3/6/2020 - Day on the Hill
Holly and Janelle were back on Capitol Hill, joining our colleagues from AACVPR and JF MAC to meet with our Representatives urging them to sign on to HR 4838. They also met with our Senators seeking their support for an upcoming companion Senate bill. They even made Senator McSally’s Facebook page! #DOTH