This bill expands Medicare coverage and provider flexibility for cardiac and pulmonary rehabilitation programs by allowing physician assistants, nurse practitioners, and clinical nurse specialists to order and supervise these essential services.
Terri Sewell
Representative
AL-7
This bill, the Increasing Access to Quality Cardiac Rehabilitation Care Act of 2025, expands access to Medicare-covered cardiac and pulmonary rehabilitation programs. It allows physician assistants, nurse practitioners, and clinical nurse specialists to order, prescribe, and supervise these essential services. The legislation also updates where these programs can be furnished to include general "office settings."
Medicare Cardiac Rehab Rules Loosen Up: NPs and PAs Can Now Order and Supervise Programs
This new bill, the Increasing Access to Quality Cardiac Rehabilitation Care Act of 2025, is a straightforward update to how Medicare handles crucial recovery programs. Essentially, it expands the roster of healthcare professionals who can order and oversee cardiac and pulmonary rehabilitation. Starting six months after the bill becomes law, Physician Assistants (PAs), Nurse Practitioners (NPs), and Clinical Nurse Specialists (CNSs) will be able to step into roles previously reserved exclusively for physicians—meaning they can order a patient’s treatment plan, prescribe the exercise component, and supervise the rehab sessions (SEC. 2).
More Hands on Deck for Recovery
Think about what happens after a major heart event or severe lung issue. Recovery often hinges on getting into a cardiac or pulmonary rehab program quickly. These programs are often limited by the availability of supervising physicians. This bill addresses that bottleneck by leveraging the skills of mid-level providers who are already highly trained in patient care. For a Medicare beneficiary living in a rural area, this change could mean the difference between waiting months for a physician-supervised slot or starting rehab within weeks under the care of a qualified NP or PA at a local clinic. This is a clear win for access, especially where physician shortages are common.
Updating the Location and the Roster
The bill also makes a small but important change to the definition of where cardiac rehab can happen. It updates the location from the restrictive “a physician’s office” to the more general “the office setting.” This seemingly minor tweak recognizes the reality that these services are often delivered in dedicated outpatient clinics or facilities that might not technically be classified as a traditional physician’s office. This flexibility, combined with expanding the supervisory pool, helps modernize Medicare’s rules to match how healthcare is actually delivered today.
The Real-World Impact on Providers
For NPs and PAs, this legislation formally recognizes and expands their scope of practice within the Medicare system, allowing them to utilize their training fully in these rehabilitation settings. For physicians, while it might mean delegating some supervision tasks, it frees up their time to focus on complex diagnostic and acute care needs, ultimately improving efficiency across the clinic. The goal here isn't to replace physicians, but to ensure that critical, time-sensitive rehabilitation services don’t get delayed because of an administrative rule about who can sign the supervision sheet. This change is all about getting people back on their feet faster by making the system work smarter.