Who can bill for CPT 93797?
Patients who begin the program within 12 months of an acute Myocardial Infarction (MI). Patients who have had Coronary Artery Bypass Graft (CABG) surgery. Patients with stable angina pectoris. Patients who have had heart valve repair/replacement.
What is the CPT code for cardiac rehab?
Cardiac Rehabilitation Program No more than two one-hour sessions, utilizing any combination of the CPT® or HCPCS codes (93798, 93797 or G0422, G0423) will be allowed per day for up to 36 sessions over a maximum of 36 weeks (Phase IIA).
Does Medicare cover 93798?
Medicare coverage of cardiac rehabilitation services is defined in the Code of Federal Regulations (42 CFR 410.49). Coverage for cardiac rehabilitation services is limited to patients with one or more of the following: Acute myocardial infarction within the preceding 12 months; or. Coronary artery bypass surgery; or.
What is the revenue code for cardiac rehab?
Group 1
| Code | Description |
|---|---|
| 93797 | PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL SERVICES FOR OUTPATIENT CARDIAC REHABILITATION; WITHOUT CONTINUOUS ECG MONITORING (PER SESSION) |
Does Medicare cover cardiac rehab for heart failure?
In 2014, Medicare expanded coverage for cardiac rehabilitation to include adults with heart failure with reduced ejection fraction, given studies showing cardiac rehab can improve physical function and reduce death and hospitalizations.
Does Medicare pay for cardiac rehab?
Original Medicare covers cardiac rehabilitation at 80% of the Medicare-approved amount. If you receive care from a participating provider, you pay a 20% coinsurance after you meet your Part B deductible ($233 in 2022).
How often can CPT 93798 be billed?
When billing CPT-4 codes 93797 and 93798, there is a maximum of two one-hour sessions per day and up to a maximum of 24 one-hour sessions over a 24-week period.
How many cardiac rehab visits Does Medicare allow?
Medicare covers up to two, one-hour cardiac rehab sessions per day, or a total of 36 sessions completed during a 36-week period. If your doctor determines that more sessions are medically necessary, Medicare will pay for an additional 36 sessions during the 36-week period.
What are 4 diagnosis that are eligible for Medicare reimbursement for Phase II cardiac rehabilitation?
Coronary artery bypass surgery. Current stable angina (chest pain) A heart valve repair or replacement. A coronary angioplasty (a medical procedure used to open a blocked artery) or coronary stent (a procedure used to keep an artery open)