Intensive Cardiac Rehabilitation (ICR) - JE Part B

ICR programs must be approved by CMS through the National Coverage Determination (NCD) process and must meet certain criteria for approval. Individual sites seeking to provide ICR services via an approved ICR program must enroll with their local Medicare contractor as an ICR program supplier. All information can be found in CMS Internet Only Manual (IOM), Publication 100-08, Chapter 15, Section 15.4.2.8

• Application Completion
• Effective Dates
• Supporting Documentation
• Resources

Application Completion

• Noridian will verify that CMS has approved the ICR program through the NCD process.
  • A list of approved ICR programs will be identified through the NCD listings, the CMS ICR Programs webpage and the Federal Register. The contractor shall use one of these options to verify that the ICR program has met CMS approval.
• An ICR supplier must separately enroll each of its practice locations.
• ICRs are able to have reassignments
• If completing application via PECOS, ensure application questionnaire is answered correctly. CMS-855B, CMS-588 (Electronic Funds Transfer (EFT)) application will populate.
• If completing application via paper, the following must be submitted:
  • CMS-855B
  • CMS-588 (EFT)
• A voided check or signed bank letter is necessary documentation for EFT portion of application
• Must include legal business name (LBN) of the enrollment, routing and account number and practice address
• CMS-460 (Participation agreement)
  • This is optional.
  • View Participation webpage for details
• Submit application fee
  • Fee is required for application. Can be paid on PECOS website
  • Select pay application fee on right-hand side under Helpful Links

Effective Dates

Medicare can go back 30 days from when the application is submitted, or all signatures are received in PECOS.

An application can be submitted 60 days in advance of when the enrollment will be active.

Supporting Documents

• IRS document when:
  • Initial enrollment
  • A change of legal business name
• A voided check or signed bank letter is necessary documentation for EFT portion of application

Resources

• CMS IOM, Publication 100-04, Medicare Claims Processing Manual, Chapter 32
• CMS IOM, Publication 100-02, Medicare Benefit Policy Manual, Chapter 15
• 42 CFR § 410.49-Federal Register