Starting from January 1, 2024, certain non-physician practitioners (NPs, PAs, CNS) have been granted the authority to provide direct supervision for cardiac rehabilitation, intensive cardiac rehabilitation, and pulmonary rehabilitation services. Moreover, during the period from January 1 to December 31, 2024, these non-physician practitioners are allowed to deliver the required direct supervision remotely through two-way audio/visual communication technology, excluding audio-only communication.
The American Hospital Association (AHA) issued the following statement regarding this change. Under the existing law, cardiac rehabilitation services (CR), intensive cardiac rehabilitation services (ICR), and pulmonary rehabilitation services (PR) must be overseen directly by a physician (medical doctor or doctor of osteopathy).
Effective January 1, 2024, the Bipartisan Budget Act of 2018 empowers PAs, NPs, and CNSs to provide direct supervision for CR, ICR, and PR. In the CY 2024 PFS final rule, the Centers for Medicare and Medicaid Services (CMS) confirms its proposed conforming amendments, allowing PAs, NPs, and CNSs to offer direct supervision for PR, CR, and ICR services. For more information on this final rule and the new direction visit this website.
Additionally, during the COVID-19 Public Health Emergency (PHE), CMS included CR, ICR, and PR in the telehealth list for non-hospital patients, covered under the PFS. CMS allowed remote direct supervision of CR, ICR, and PR by a physician using two-way audio/visual communication technology, excluding audio-only communication.
These flexibilities were legislatively extended until December 31, 2024, by the Consolidated Appropriations Act (CAA). To maintain consistency with the physician fee schedule (PFS) rules, CMS also extended these flexibilities under the Outpatient Prospective Payment System (OPPS) in previous rulemaking.
“This is wonderful news for CR sites to be able to use a Non-Physician Practitioner for direct supervision. The previous direction of needing a MD or DO on-site during cardiac or pulmonary rehab has been a barrier that has led to several programs closing. This new final rule will hopefully open more programs and provide a needed service to the community members. It is a win, a win for all,” shared Dee Kaser, RN, CDCES; Great Plains QIN Quality Improvement Advisor.
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Cardiac Rehab Do It For Your Heart: Following a diagnosis of heart attack or heart failure, or after a procedure such as a heart stent or heart surgery, participating in cardiac rehab is one of the best things you can do for your heart.