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Outpatient Physical Therapy Management of Cardiovascular Disease

presented by Ellen Hillegass, PT, EdD, CCS, FAPTA and Morgan Johanson, PT, MSPT, CCS

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Disclosure Statement:

Financial: Ellen Hillegass is the owner and CEO of PT Cardiopulmonary Educators, a web-based continuing education company. She receives royalties from two books: Essentials of Cardiopulmonary Physical Therapy and PT Clinical Notes. She is also an employee and receives wages from South College Knoxville and South College Atlanta. She receives compensation from MedBridge for this course.

Nonfinancial: Ellen Hillegass is a volunteer with the Academy of Cardiovascular & Pulmonary PT of the APTA. She has no competing nonfinancial interests or relationships with regard to the content presented in this course.

Financial: Morgan Johanson is the president of Good Heart Education, a web-based continuing education company. She receives payment as contributing author of Essentials of Cardiopulmonary Physical Therapy. She receives compensation from MedBridge for this course.

Nonfinancial: Morgan Johanson is the professional development chair for the Academy of Cardiovascular & Pulmonary Physical Therapy. She has no competing nonfinancial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

MedBridge is committed to accessibility for all of our subscribers. If you are in need of a disability-related accommodation, please contact [email protected]. We will process requests for reasonable accommodation and will provide reasonable accommodations where appropriate, in a prompt and efficient manner.

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Video Runtime: 66 Minutes, Learning Assessments: 23 Minutes

There is a lack of cardiac rehabilitation programs across the country to provide adequate care to all the patients with cardiovascular deficits. Due to the cardiovascular deficits seen in many patients post SARS-CoV-2 infection, as well as the limitation in the number of outpatient cardiac rehabilitation centers, many outpatient physical therapy clinics are creating programs designed to treat patients with cardiovascular disease. Due to the fragility of these patients, clinicians are seeking further education for the management guidelines for this patient population. This course will discuss the purpose of cardiac rehabilitation, specific Medicare requirements for cardiac rehabilitation, staffing, examples of structured programs, billing, and logistics. This course will provide answers to frequently asked questions and will include information on telehealth, home health, and other patients with cardiovascular disease who do not meet Medicare requirements for cardiac rehabilitation. After this course, clinicians will have the necessary information to be able to start a program in their clinic.

Meet Your Instructors

Ellen Hillegass, PT, EdD, CCS, FAPTA

Dr. Ellen Hillegass is a physical therapist with APTA board certification in the cardiovascular and pulmonary clinical specialty. She is currently a professor on the core faculty at South College Knoxville and South College Atlanta and is an adjunct professor at Mercer University in Atlanta in the department of physical therapy. Ellen is also the…

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Morgan Johanson, PT, MSPT, CCS

Morgan Johanson has more than 20 years of experience practicing physical therapy in the cardiovascular and pulmonary patient population. She is a board-certified cardiovascular and pulmonary specialist and an APTA-certified advanced clinical instructor. Morgan is the president of Good Heart Education, a continuing education company that provides in-person and online seminars in cardiovascular and pulmonary…

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Chapters & Learning Objectives

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1. Overview of Cardiac Rehabilitation (CR)

This chapter covers the definition and purpose of cardiac rehabilitation. Program requirements, appropriate diagnoses, and contraindications for therapy are also discussed. Clinicians will learn how to stratify their patients’ risk to be able to apply interventions safely and effectively in the clinic.

2. Medicare Requirements for Cardiac Rehabilitation

This chapter will discuss the Medicare requirements for cardiac rehabilitation, including physician-prescribed exercise, risk factor modification, psychosocial assessments, outcome assessments, individualized treatment plans, and setting requirements. This is an important chapter as anyone setting up a cardiac rehabilitation program must follow Medicare guidelines in order to be reimbursed and not raise flags for an audit.

3. Staffing in Cardiac Rehabilitation

This chapter describes the typical staff seen in cardiac rehabilitation clinics, including the medical director. We will discuss the core competencies required for physical therapists and the role of PT assistants in outpatient cardiac rehabilitation. For clinics wishing to start a program, this is important logistical information to ensure proper staffing for reimbursement.

4. Examples of Program Structure

This chapter will provide the typical cardiac rehabilitation program structure as well as examples of existing cardiac rehabilitation programs. Typical equipment used in cardiac rehabilitation will also be provided. Individuals starting cardiac rehabilitation programs benefit when they have a model to use to develop their program.

5. Billing and Logistics in Cardiac Rehabilitation

This chapter will cover the Medicare billing codes and requirements and discuss possible patient co-payment. Billing requirements for Medicare Advantage, private-pay insurance, and Medicaid will also be discussed. Options for billing codes for patients in need of cardiac rehabilitation services who do not meet Medicare requirements will be presented. We will also talk about telehealth and home health options for patients who cannot attend a center-based program. This is important for clinics to ensure reimbursement for services.

6. Frequently Asked Questions and Answers

Five to eight questions will be presented, along with answers to these questions. These questions come from clinicians who have asked for assistance in developing and structuring their programs and will help others who are in the development or restructuring phase of their cardiac rehabilitation programs.

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