Cardiac Rehabilitation Patient Referral From an Outpatient Setting

Exceptions criteria require documentation of one or more of the following factors that may prohibit cardiac rehabilitation participation: Medical factors (e.g., patient deemed by provider to have a medically unstable, life-threatening condition). Health care system factors (e.g., no cardiac rehabilitation/secondary prevention (CR/SP) program available within 60 min of travel time from the patient’s home).

The only exclusion criterion for this measure is noted below: Patients already referred to CR from another provider/facility and/or was participating in CR prior to encounter with provider at the current office/facility.(1) When the provider discusses CR/SP referral with the patient, if the patient indicates that he/she has already been referred to CR/SP, then that provider would not be expected to make another referral. However, the provider should document that information in the medical record.