CMS Benson-Henry Institute Cardiac Wellness Program Form

Effective Date

05/06/2014

Last Reviewed

NA

Original Document

  Reference



Background for this Policy

A.      General

The fundamental concepts of the Benson-Henry Institute Cardiac Wellness Program were developed by Herbert Benson, MD, over 40 years ago. Benson states that “in the middle 1960s, when I noticed that people’s blood pressures were higher during visits to my office than at other times and wondered whether stress wasn’t causing that rise. Stress wasn’t on the radar then, so I began investigating a connection between stress and hypertension.” (http://www.ideafit.com/fitness-library/mind-body-medicine-balanced-approach) The Cardiac Wellness Program is a multi-component intervention program that includes supervised exercise, behavioral interventions, and counseling, and is designed to reduce cardiovascular risk and improve health outcomes.

B.      Nationally Covered Indications

Effective for claims with dates of service on and after May 6, 2014, the Benson-Henry Institute Cardiac Wellness Program meets the Intensive Cardiac Rehabilitation (ICR) program requirements set forth by Congress in §1861(eee)(4)(A) of the Social Security Act, and in regulations at 42 C.F.R. §410.49(c) and, as such, has been included on the list of approved ICR programs available at http://www.cms.gov/Medicare/Medicare-General-Information/MedicareApprovedFacilitie/.

C.      Nationally Non-Covered Indications

Effective May 6, 2014, if a specific ICR program is not included on the above-noted list as a Medicare-approved ICR program, it is non-covered.

D.      Other

N/A

(This NCD last reviewed May 6, 2014.)