AACVPR News & Views - March/April 2017 - 11

INSIDE >> THE INDUSTRY

Invite the provider to your
program to provide information
regarding cardiac and pulmonary
rehab and discuss what level of
involvement is agreeable to each.
You may want to start small to test
the waters.
Regarding a contractual
arrangement, there may be a cost
center sharing arrangement if
the provider is a member of your
hospital or university staff. If you
choose a community provider, you
will need to develop a mutually
agreeable financial contract.

billing units for each patient.
And yes, this frequently does
require a shift in our thinking
of the definition of traditional
"comprehensive" cardiac
rehab. Of course, exercise is
the mainstay of cardiac rehab.
Indeed, exercise is an incredible
benefit for the long term health
of our patients - as long as they
exercise. A strong psychosocial

component can contribute to
improved long-term outcomes.
This is what we want, and it is
what CMS wants. 
Reference
Blumenthal JA, Sherwood A, Smith PJ,
et al. Enhancing cardiac rehabilitation
with stress management training: a
randomized clinical efficacy trial. Circulation. Published online March 21,
2016.1993;103:1362-1368.

Of course, programs need to
question the affordability of a
contracted psychosocial provider.
It is affordable, particularly when
using the CPT code 93797. It is
now possible and encouraged by
Medicare and AACVPR to address
our patients' broader concerns
within the rehab program. We now
know this care can significantly
impact outcomes.
The aforementioned code is
to be used for programming
other than ECG-monitored
exercise. This includes its use
for billing individual psychosocial
consultation and group stress
management programming.
The 93797 CPT code generally
reimburses at the same rate as
traditional 93798 CPT code.
Therefore, it is not difficult to
develop a model that adequately
covers a provider's contracted
rate and allows the program to
make money.
Yes, the use of this code does
count toward the total allowed
News&Views MARCH/APRIL 2017 11
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