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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