Outpatient Cardiac Rehabilitation

Outpatient cardiac rehabilitation (Phase II) — physician‑supervised, ECG‑monitored, physician‑prescribed exercise sessions — is covered for patients with coronary disease and related conditions such as recent MI, PCI, CABG, stable CAD, NYHA class II–IV heart failure, recent heart or heart‑lung transplant, valve surgery, PAD, and survivors of sustained ventricular arrhythmia/sudden cardiac arrest. Coverage is limited to ≤36 visits over ≤9 months, requires clinical stability (no unstable angina, decompensated HF, uncontrolled arrhythmias, active infection/endocarditis, severe aortic stenosis, etc.), heart‑failure patients must be on optimal therapy ≥6 weeks, and Phase III/IV or intensive programs and requests for additional visits are not routinely covered without medical‑director review.

"Stable angina pectoris within the last 12 months"

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