Starting January 1, 2024, certain non-physician practitioners (NP, PA, CNS) are permitted to provide direct supervision for cardiac rehabilitation, intensive cardiac rehabilitation, and pulmonary rehabilitation services. In addition, starting Jan. 1 through Dec. 31, 2024, these non-physician practitioners may provide the required direct supervision remotely via two-way, audio/visual communication technology (but not audio only).
The American Hospital Association (AHA) released the following advisory regarding the change:
Under current law, cardiac rehabilitation services (CR), intensive cardiac rehabilitation services (ICR) and pulmonary rehabilitation services (PR) must be provided under the direct supervision of a physician (medical doctor or doctor of osteopathy). Effective Jan. 1, 2024, the Bipartisan Budget Act of 2018 authorizes CR, ICR and PR to be furnished under the direct supervision of a physician assistant (PA), nurse practitioner (NP) or clinical nurse specialist (CNS). In the CY 2024 PFS final rule, the Centers for Medicare and Medicaid Services (CMS) finalizes its proposed conforming amendments to provide that PAs, NPs and CNSs may provide direct supervision of PR, CR and ICR services. In addition, during the COVID-19 PHE, CMS added CR, ICR and PR to the telehealth list when furnished to non-hospital patients and paid under the PFS. CMS permitted direct supervision of CR, ICR and PR to be furnished remotely by a physician via two-way, audio/visual communication technology (but not audio only). These flexibilities were extended by law through Dec. 31, 2024, by the Consolidated Appropriations Act (CAA). For consistency with the physician fee schedule (PFS) rules, in prior rulemaking, CMS also extended these flexibilities under the OPPS.
In addition, during the COVID-19 PHE, CMS added CR, ICR and PR to the telehealth list when furnished to non-hospital patients and paid under the PFS. CMS permitted direct supervision of CR, ICR and PR to be furnished remotely by a physician via two-way, audio/visual communication technology (but not audio only). These flexibilities were extended by law through Dec. 31, 2024, by the CAA. For consistency with the PFS rules, in prior rulemaking, CMS also extended these flexibilities under the OPPS.
For more information, please contact SDAHO’s Director of Advocacy and Reimbursement, Jacob Parsons.
