Cardiac and pulmonary rehab marketing: eligibility

Cardiac and pulmonary rehabilitation programs sit in an unusual spot for marketing. The people who need them have just been through a heart attack, a bypass operation, a valve procedure or a hard stretch with lung disease, and they are deciding whether to show up two or three times a week for months. The program has to reach them, explain what it is and make joining easy. At the same time, Medicare defines these programs closely: who qualifies, who has to prescribe and sign the plan, where sessions can happen, the number of sessions covered and what an intensive program has to prove before it can use that name. A program page that drifts from those definitions makes promises the program cannot keep. This guide sets out the rules a hospital outpatient department or physician practice running a rehab program should build its website, referral materials and outreach around.

Two related topics have their own guides and are not repeated here. Heart screening offers, device wording, the physician self-referral law for in-office testing and emergency messaging on a heart practice website are covered in our cardiology practice marketing guide. Condition pages for COPD and asthma, lung function testing and the patient-facing Medicare.gov wording for pulmonary rehab are in our pulmonology practice marketing guide. For COPD flare wording and home oxygen pages, see COPD program marketing.

This is general information, not legal or medical advice. Sources cited were checked on October 30, 2026: 42 CFR 410.47 and 410.49, 42 U.S.C. 1395x(eee) and (fff), section 6211 of the Consolidated Appropriations Act, 2026 (Public Law 119-75, February 3, 2026), the Medicare.gov pages Cardiac rehabilitation programs and Pulmonary rehabilitation programs, 42 U.S.C. 1320a-7a and 1320a-7b, 45 CFR 164.501, 47 CFR 64.1200, 15 U.S.C. 45 and 52, and the FTC policy statements on deception and advertising substantiation. Payment amounts and billing codes are not covered here. Medicare Advantage plans, other payers and state rules can add their own conditions, set plan by plan and state by state.

What Medicare means by cardiac and pulmonary rehab

42 CFR 410.49(a) defines cardiac rehabilitation as a physician or nonphysician practitioner supervised program that furnishes physician prescribed exercise, cardiac risk factor modification, psychosocial assessment and outcomes assessment. 42 CFR 410.47(a) defines pulmonary rehabilitation as a physician or nonphysician practitioner supervised program for COPD and certain other chronic respiratory diseases designed to optimize physical and social performance and autonomy. In both rules, nonphysician practitioner means a physician assistant, nurse practitioner or clinical nurse specialist.

Each program has to include the same building blocks. For cardiac rehab, 410.49(b)(2) lists physician prescribed exercise each day services are furnished, risk factor modification including education, counseling and behavioral intervention tailored to the individual, a psychosocial assessment, an outcomes assessment, and an individualized treatment plan. For pulmonary rehab, 410.47(b)(2) lists physician prescribed exercise during each session, education or training tied to the person’s care, including respiratory problem management and, if appropriate, brief smoking cessation counseling, plus the same assessments and plan. In both, the plan must be established, reviewed and signed by a physician every 30 days.

Those components give you the honest outline of a program page. Describe the exercise sessions, the education on risk factors or breathing, the check-ins on how the person is coping, the measurements taken at the start and end, and the written plan that a physician reviews. That is more useful to a nervous patient than a slogan, and every line of it is something the program is required to do anyway.

Who qualifies, written the way the rules list it

Under 410.49(b)(1), Medicare Part B covers cardiac rehabilitation and intensive cardiac rehabilitation for people who have had one or more of the following: an acute myocardial infarction within the preceding 12 months, coronary artery bypass surgery, current stable angina, heart valve repair or replacement, coronary angioplasty or stenting, a heart or heart-lung transplant, or stable chronic heart failure as the regulation defines it, which is a left ventricular ejection fraction of 35 percent or less with class II to IV symptoms despite at least 6 weeks of optimal heart failure therapy. Other conditions can be added through a national coverage determination.

The Medicare.gov page puts the same list in plain words: a heart attack in the last 12 months, coronary artery bypass surgery, stable angina pectoris (chest pain), a heart valve repair or replacement, a coronary angioplasty or coronary stenting, a heart or heart and lung transplant, and stable chronic heart failure. That plain version is the one to use on a patient page, with a link to Medicare.gov. Keep the 12 month window on the heart attack line; dropping it widens the offer beyond what Medicare covers.

For pulmonary rehab, 410.47(b)(1) covers people with moderate to very severe COPD, defined as GOLD classification II, III and IV, when referred by the physician treating the chronic respiratory disease, and people who have had confirmed or suspected COVID-19 and have persistent symptoms that include respiratory dysfunction for at least four weeks. Our pulmonology guide linked above covers how the Medicare.gov page states this for patients.

Avoid copy that turns a coverage list into a general invitation. Lines like anyone with heart problems can join, or rehab for all lung conditions, suggest Medicare coverage for people the rules do not cover. If your program also accepts people outside the Medicare criteria, for example on another payer or as self-pay, say so as a separate statement with its own cost information.

The physician’s role: say it plainly

A person cannot simply sign up for a Medicare-covered rehab program the way they join a gym. The exercise has to be prescribed by a physician, and a physician has to establish, review and sign the treatment plan every 30 days. For pulmonary rehab for COPD, the regulation adds that the person is covered when referred by the physician treating the chronic respiratory disease.

Say this on the program page in one or two clear sentences, near the top, for example: to start cardiac rehab, your doctor will need to refer you, and if you are not sure whether you qualify, ask your cardiologist or the team that treated you. Then make the next step easy. A contact form can ask whether the person already has a referral and who their treating doctor is, and staff can follow up. Do not imply that filling in the form enrolls the person or that the program will decide eligibility on its own.

Pages written for referring clinicians are the other half. They can list the covered conditions, explain how to send a referral, say what the program sends back (progress notes, the outcomes assessment at the end), and give a direct phone line. Our guide to patient and physician referrals covers how to build referral relationships without the problems described further down.

Regular and intensive cardiac rehab are not interchangeable words

Intensive cardiac rehabilitation is a defined term. Under 410.49(a) and (c), an intensive program is one that has shown in peer-reviewed published research that it improves patients’ cardiovascular disease through specific outcome measures. CMS identifies approved intensive programs through the national coverage determination process and posts the list, and each site that wants to provide one must apply to enroll as an intensive cardiac rehabilitation program site.

So do not call your program intensive, or describe it with that term in ads, unless it uses an approved intensive program and your site is enrolled to provide it. A busy, well-staffed regular program is still a regular program in Medicare’s terms. The reverse matters too: if you do run an approved intensive program, the research behind the approval belongs to the program’s developers. It is not evidence of your own site’s results, and the claims section below applies.

Session numbers follow the same logic. Under 410.49(f), regular cardiac rehab is limited to a maximum of 2 one-hour sessions per day for up to 36 sessions over up to 36 weeks, with the option of an additional 36 sessions over an extended period if approved by the Medicare Administrative Contractor. Intensive cardiac rehab is limited to 72 one-hour sessions, up to 6 per day, over up to 18 weeks. 410.47(e) sets the same limits for pulmonary rehab as for regular cardiac rehab. If your page mentions a number of sessions, use these figures and keep the condition on the extra sessions. Do not present 72 regular sessions as the standard program.

Settings, supervision and what supervised can mean on your page

Under 410.49(b)(3) and 410.47(b)(3), Medicare Part B pays for these programs in a physician’s office or a hospital outpatient setting, and every setting must have a physician or nonphysician practitioner immediately available and accessible for medical consultations and emergencies at all times while services are furnished. Pulmonary rehab settings must also have the necessary emergency and life-saving equipment, and the rule gives oxygen, resuscitation equipment and a defibrillator as examples. The Medicare.gov cardiac page adds that the hospital outpatient setting includes a critical access hospital.

Both rules also set standards for the people involved. The medical director must have expertise in managing people with cardiac or respiratory conditions, basic or advanced life support training and a license to practice medicine in the state where the program is offered. Supervising practitioners need the same expertise and life support training.

These requirements support honest lines such as medically supervised sessions, or a physician or advanced practice clinician is available on site during every session. They do not support claims your staffing does not match. A page that says a cardiologist is with you at every session, or that every session is one to one, has to be true at every session the program runs, including early mornings and holidays. Name roles, not individual credentials you cannot keep current, and update the page when staffing changes.

Virtual sessions at home: a dated window

Section 6211 of the Consolidated Appropriations Act, 2026, signed February 3, 2026, amended 42 U.S.C. 1395x(eee)(2)(A)(ii). The program setting described as a hospital on an outpatient basis now includes items and services furnished through audio and video real-time communications technology, excluding audio-only, on or after January 31, 2026, and before January 1, 2028, in the home of an individual who is an outpatient of the hospital. The pulmonary rehab definition in 1395x(fff) refers back to the program description in (eee)(2), and the section is titled in-home cardiopulmonary rehabilitation flexibility.

Four points follow for marketing. First, the text speaks of hospital outpatients, so a physician office program should not read it as covering its own home sessions. Second, it requires audio and video together; a phone-only check-in does not fit the wording. Third, the window ends before January 1, 2028, so any page that offers home sessions should carry that end date or be reviewed before it passes. Fourth, the law lets HHS implement the change by program instruction, so check the current CMS and Medicare Administrative Contractor instructions before you advertise home sessions as covered. Our telehealth marketing guide covers the general rules for virtual care pages.

Cost wording

The Medicare.gov cardiac rehab page says that in a doctor’s office, after you meet the Part B deductible, you pay 20% of the Medicare-approved amount, and that in a hospital outpatient setting you also pay the hospital a copayment. The pulmonary rehab page says the same, adding that the hospital copayment applies every session. Both pages tell people to ask their provider how much a service will cost.

That rules out free cardiac rehab or no cost to you in general copy. For a program running two or three sessions a week, a copayment per session is a real figure for a patient, and leaving it out of a page is the kind of omission that the FTC treats as misleading when it changes how people decide. Use the Medicare.gov wording, add that Medicare Advantage members and people with other coverage should check with their plan, and offer a staff contact who can look up a person’s costs before the first session. Our guide to marketing to Medicare patients covers the rules on waiving copayments and offering things of value to beneficiaries.

Referral sources, rides and gifts

A rehab program depends on referrals from cardiologists, pulmonologists, surgeons and hospital discharge teams, which makes the federal anti-kickback statute central. 42 U.S.C. 1320a-7b(b) makes it a crime to knowingly and willfully offer or pay remuneration to induce referrals of items or services payable by a federal health care program. Paying a referring physician per patient, giving free staff to a referring office, or offering meals and gifts tied to referral volume are the arrangements to keep out of a referral plan. Statutory exceptions and regulatory safe harbors exist, and an arrangement has to meet every condition of one to rely on it, so review referral arrangements with counsel.

On the patient side, 42 U.S.C. 1320a-7a(a)(5) provides civil penalties for offering remuneration to a Medicare or Medicaid beneficiary that the person offering it knows or should know is likely to influence the beneficiary to choose a particular provider or supplier. A gift card for enrolling, or a free month of a gym membership advertised to draw people to your program, raises that question. Rides to sessions are a real need for people recovering from heart surgery, and the statute has exceptions, but whether a transportation offer fits one depends on its terms. Settle that with counsel before transportation appears in any ad.

Outcome claims

Under 15 U.S.C. 45 and 52, advertising must not be deceptive, and the FTC policy statements say objective claims need a reasonable basis before they run and that the net impression of an ad counts, including implied claims. For a rehab program, that covers lines like get your life back, reverse heart disease, breathe like you used to, or any survival, readmission or hospital-stay figure.

Do not put survival or outcome numbers on a page unless you quote them exactly, name the source and date, and make clear what population the number describes. A published study on rehab in general is not a statement about your program, and the peer-reviewed research behind an approved intensive program describes that program’s research results, not what a given patient will experience at your site. If you publish your own program measures, keep the records, define the measure, and say who was counted and who was not.

The rules give you plenty of accurate language. The program includes exercise prescribed by a physician, education on risk factors or breathing, assessments at the start and end and a written plan reviewed every 30 days. Describing that, in plain words, is a stronger page than a promise.

Cardiac rehab follows a heart event. Adults who have not had one, and who have not had their blood pressure, cholesterol or cardiovascular risk checked, are invited to a different service; our guide to heart health screening outreach covers the USPSTF wording, the 911 line and free screening offers.

Privacy and outreach messages

Rehab outreach carries health information by its nature: a reminder that names cardiac rehab tells anyone who reads it that the person has a heart condition. Under 45 CFR 164.501, a covered entity’s communication describing a health-related service it provides, or a communication for treatment or care coordination, is excluded from the definition of marketing unless the covered entity receives financial remuneration from a third party for making it. That lets a hospital or practice invite its own eligible patients, but the messages still belong in tools set up for health information.

Calls and texts are subject to the Telephone Consumer Protection Act rules at 47 CFR 64.1200, which set consent requirements for autodialed and prerecorded calls and texts to wireless numbers. Get consent for texts at intake, keep reminders free of clinical detail, and honor opt-outs. Our text message reminders guide covers the mechanics.

A rehab website is also read by people with chest pain or sudden breathlessness. Put a short line on program pages and contact forms saying that anyone with symptoms of a heart attack or a medical emergency should call 911, and that the form and inbox are not monitored for urgent care.

Illustration: two program pages

Illustration: A hospital outpatient rehab program publishes a page headed Free heart rehab, join today. It says anyone recovering from a heart problem can sign up online, promises an intensive 72 session program with a cardiologist at every session, offers home sessions by phone, shows a statistic about lower death rates without a source, and gives a gift card to people who finish. Almost every line conflicts with a rule above: cost, eligibility, the physician’s role, the intensive label, staffing, the audio and video requirement, outcome claims and beneficiary inducements.

Illustration: The rewritten page explains what cardiac rehab includes in the regulation’s terms, lists the covered conditions from Medicare.gov with the 12 month window, says a doctor will need to refer the person and offers to help contact their doctor, describes the regular program and its session limit with the condition on extra sessions, says a physician or advanced practice clinician is available during every session, notes that video sessions at home are available to hospital outpatients until the end of 2027 if CMS instructions still allow them, uses the Medicare.gov cost wording with a staff contact for questions, tells people with emergency symptoms to call 911, and leaves out outcome figures and gifts.

Checklist

The program is described with the components in 410.49(b)(2) or 410.47(b)(2), in plain words.
Eligibility lines follow 410.49(b)(1) or 410.47(b)(1) and the Medicare.gov pages, including the 12 month window for a heart attack.
The page says plainly that a physician has to refer the person or prescribe the program, and the form does not suggest it enrolls anyone.
Intensive is used only for an approved intensive program at an enrolled site.
Session numbers match 410.49(f) or 410.47(e), with the contractor approval condition on additional sessions.
Supervision lines match actual staffing at every session.
Home sessions are offered only by a hospital outpatient program, by audio and video, with the January 1, 2028 end date and current CMS instructions checked.
Cost lines use the Medicare.gov wording, with the hospital copayment where it applies and a staff contact for questions.
No per-referral payments, free staff or gifts tied to referral volume; transportation and patient gifts reviewed with counsel.
No survival, readmission or recovery figures unless quoted exactly, sourced, dated and described.
Reminders and forms run in tools set up for health information, with text consent at intake.
Program pages and forms tell people with emergency symptoms to call 911.

How we help

We build websites, local search, Google Ads and AI front desk tools for independent practices and health businesses. For a cardiac or pulmonary rehab program, that means a website page that explains the program and eligibility the way the rules state them, a referral page for clinicians, and inquiry flows that ask about referrals and send coverage questions to staff who can check them. Our tools are built with HIPAA in mind. We confirm in writing what a BAA covers before any patient information flows through a tool, and if it is not covered, we do not route patient information through it. We are not a healthcare provider and we do not give legal or medical advice. We do not sell lead lists and we do not pay for referrals. For the wider rules, see our healthcare marketing rules hub.

Who qualifies for Medicare-covered cardiac rehab?

Under 42 CFR 410.49(b)(1), people who have had a heart attack within the preceding 12 months, coronary bypass surgery, current stable angina, a heart valve repair or replacement, coronary angioplasty or stenting, a heart or heart-lung transplant, or stable chronic heart failure as the regulation defines it. Other conditions can be added through a national coverage determination.

Can patients sign up for rehab without a doctor?

Not for the Medicare-covered program. The exercise must be prescribed by a physician and a physician must sign the treatment plan every 30 days. For pulmonary rehab for COPD, the regulation covers people referred by the physician treating the disease.

Can we call our program intensive cardiac rehab?

Only if it uses a program approved through the national coverage determination process and your site is enrolled as an intensive cardiac rehabilitation site under 42 CFR 410.49(c).

Can we offer rehab sessions at home by video?

Section 6211 of the Consolidated Appropriations Act, 2026 lets hospital outpatient programs furnish services by audio and video, not audio only, in the patient’s home from January 31, 2026 until before January 1, 2028. Check current CMS and contractor instructions before advertising it.

Can we say rehab is free with Medicare?

No. Medicare.gov says you pay 20% of the Medicare-approved amount after the Part B deductible, and in a hospital outpatient setting you also pay the hospital a copayment. Use that wording and offer a staff contact for cost questions.

Can we share statistics about rehab lowering death rates?

Only if you quote the figure exactly, name the source and date, and make clear it describes a study population and not your program’s results. Claims about your own program need records behind them.

Sources

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Cardiac and pulmonary rehab program marketing: eligibility, referrals, home sessions and claims