Medicare Final 2020 Cardiac & Pulmonary Rehabilitation ...

[Pages:1]Medicare: Final 2020 Cardiac & Pulmonary Rehabilitation Payment Rates CMS has published final payment rates for cardiac and pulmonary rehabilitation (CR/PR) reimbursement rates. The following rates are for CR and PR services provided in a hospital outpatient program that is located on-campus or in an off-campus program at a location that precedes November 2015 (i.e., "excepted" or grandfathered). All other hospital outpatient CR/PR services that are off-campus are nonexcepted and consequently reimbursed at an amount comparable to Physician Fee Schedule rates (a reduction in reimbursement of 40% or more). 2020 OPPS (Hospital Outpatient) Reimbursement Rates-Final (11-1-19) *Rates reflect hospital outpatient services at on-campus and excepted off-campus locations

CPT/HCPCS CODE

SERVICE

APC

PAYMENT RATE

CO- REVENUE CODE PAY

93668

Peripheral Vascular Rehab

5733 55.01

11.01 943

93798

Cardiac rehab/monitor 5771 110.02

22.01 943

93797

Cardiac Rehab

5771 110.02

22.01 943

93797 G0422 G0424 G0237 G0238 G0239

Intensive cardia rehab 5771 110.02 /w exercise

Intensive cardiac rehab/no exercise

5771 110.02

Pulmonary rehab/w exercise

5733 55.01

Therapeutic procedures/ strength, endurance

5731 22.98

Other respiratory proc, 5731 22.98 individual

Other respiratory proc, 5732 33.48 group

22.01 943

22.01 943

11.01 948

4.60

410

4.60

410

6.69

410

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