Medicare Heart and Breathing Benefits: Rehabilitation, Devices, and Testing

Adapted from Your Medicare Benefits, Centers for Medicare & Medicaid Services. The selected guidance concerns Medicare coverage and payment, not a recommendation for medical treatment. Numbered page references below refer to the linked source publication.

Coverage can depend on medical necessity, the setting, provider participation, and your plan’s rules. Use the cited publication for the full conditions and check the plan year when comparing costs or enrollment choices.

Cardiac rehabilitation programs

Regular and intensive cardiac rehabilitation programs include exercise, education, and counseling if you’ve experienced a heart attack, heart failure, or certain other heart problems. Part B covers these comprehensive programs if you’ve had at least one of these conditions:

• A heart attack in the last 12 months
• Coronary artery bypass surgery
• Stable angina pectoris (chest pain)
• A heart valve repair or replacement
• A coronary angioplasty (a medical procedure used to open a blocked artery) or a coronary stenting (a procedure used to keep an artery open)
• A heart or heart and lung transplant
• Stable chronic heart failure

Costs

• For services you get in a doctor’s office: After you meet the Part B deductible, you pay 20% of the Medicare-approved amount.
• For services you get in a hospital outpatient setting: After you meet the Part B deductible, you also pay the hospital a copayment.

Things to know You can get these services in a doctor’s office or a hospital outpatient setting (including a critical access hospital) that offers regular and intensive cardiac rehabilitation programs.

More information Visit Medicare.gov/coverage/cardiac-rehabilitation-programs.

Cardiovascular behavioral therapy

Cardiovascular behavioral therapy helps lower your risk for cardiovascular disease (conditions that affect the heart and blood vessels). Part B covers a cardiovascular behavioral therapy visit with your primary care doctor or other primary care practitioner in a primary care setting (like their office). During therapy, your primary care practitioner may discuss aspirin use, check your blood pressure, and give you tips on diet and exercise.

How often Once a year.

Costs You pay nothing if your primary care practitioner accepts assignment.

More information Visit Medicare.gov/coverage/cardiovascular-behavioral-therapy.

Cardiovascular disease screenings

Cardiovascular disease screenings check for problems with your heart and blood vessels, and find out if you’re at risk for heart disease. Part B covers screenings that include blood tests for cholesterol, lipid, and triglyceride levels that help find conditions that may lead to a heart attack or stroke.

How often Once every 5 years.

Costs You pay nothing if your doctor or other health care provider accepts assignment.

More information Visit Medicare.gov/coverage/cardiovascular-disease-screenings.

Cardiovascular risk assessment & management services

If you haven’t been diagnosed with cardiovascular disease, Part B may cover a cardiovascular risk assessment if your doctor or other health care provider determines you’re at risk for developing the disease. The assessment calculates your risk level using:

• Demographic data (like age and sex)
• Routine measurements (like blood pressure and weight)
• Smoking history and alcohol use
• Physical activity levels
• Laboratory data (like lipid panels to check your cholesterol levels)

As part of your risk assessment, you’ll get a 10-year estimate of your risk for developing cardiovascular disease. For people at intermediate, medium, or high risk, Part B may also cover risk management services. These services might help lower your risk of cardiovascular disease and may include:

• Blood pressure management
• Cholesterol management
• Help to stop smoking

Costs After you meet the Part B deductible, you pay 20% of the Medicare-approved amount.

More information Visit Medicare.gov/coverage/cardiovascular-risk-assessment-management-services.

Defibrillators

Medicare may cover an implantable cardioverter defibrillator if you’ve been diagnosed with heart failure. Part A covers the surgery to implant a defibrillator in a hospital inpatient setting. Part B covers the surgery if you get it in a hospital outpatient setting.

Costs

• After you meet the Part B deductible, you pay 20% of the Medicare-approved amount for your doctor’s services.
• If you get the surgery in a hospital outpatient setting, the Part B deductible applies and you’ll also pay the hospital a copayment. In most cases, the hospital copayment can’t be more than the Part A hospital stay deductible ($1,736 in 2026).
• For Part A inpatient hospital cost information, go to pages 58–59.

More information Visit Medicare.gov/coverage/defibrillators.

Pulmonary rehabilitation programs

Pulmonary rehabilitation programs help you breathe better, get stronger, and live more independently. Part B covers a comprehensive pulmonary rehabilitation program if:

• You have moderate to very severe chronic obstructive pulmonary disease (COPD) and have a referral from the doctor who’s treating it.
• You’ve had confirmed or suspected COVID-19 and experience persistent symptoms, including respiratory dysfunction for at least 4 weeks.

Costs You pay 20% of the Medicare-approved amount if you get the service in your doctor’s office. You also pay a copayment each session if you get the service in a hospital outpatient setting. The Part B deductible applies.

Things to know You can get these services in a doctor’s office or a hospital outpatient setting that offers pulmonary rehabilitation programs.

More information

• Go to “Telehealth” on page 108.
• Visit Medicare.gov/coverage/pulmonary-rehabilitation-programs.

Respiratory assist devices

Respiratory assist devices can help with breathing. Part B covers respiratory assist devices (like home mechanical ventilators and bi-level respiratory assist devices) if you’ve been diagnosed with chronic obstructive pulmonary disease (COPD) and developed chronic respiratory failure (a condition where you have low oxygen and/or high carbon dioxide levels in your blood, making it difficult to breathe on your own). You must meet certain conditions to qualify, including:

• You have hypercapnia (high levels of carbon dioxide in your blood) of 52 mmHg or more
• Your hypercapnia isn’t primarily caused by sleep apnea (a sleeping disorder where your breathing repeatedly stops and starts)

Costs After you meet the Part B deductible, you pay 20% of the Medicare-approved amount.

How often Medicare initially covers respiratory assist devices for 6 months. After that, Medicare may continue to cover the device if your doctor or other health care provider certifies that you meet certain criteria and the device is helping you. You must meet with your health care provider at least twice during the first year you have the device (once within the first 6 months, and again during the next 6 months).

More information Go to “Durable medical equipment (DME)” on pages 41–42.

Continuous Positive Airway Pressure (CPAP) therapy

CPAP therapy is an in-home treatment for people with sleep apnea. Medicare may cover a 12-week trial of CPAP therapy (including devices and accessories) if you’ve been diagnosed with obstructive sleep apnea. After the trial period, Medicare may continue to cover CPAP therapy if you meet with your doctor or other health care provider in person, and they document in your medical record that you meet certain conditions and the therapy is helping you.

Costs After you meet the Part B deductible, you pay 20% of the Medicare-approved amount for the machine rental and related supplies (like masks and tubing).

Things to know

• If you had a CPAP machine before you got Medicare and you meet certain requirements, Medicare may cover a rental or replacement CPAP machine and/or CPAP accessories.
• Medicare pays the supplier to rent a CPAP machine for 13 months, as long as you’re using it continuously. After Medicare makes rental payments for 13 continuous months, you’ll own the machine.

More information

• Go to “Durable medical equipment (DME)” on pages 41–42.
• Visit Medicare.gov/coverage/continuous-positive-airway-pressure-devices.

Source and further reading

Your Medicare Benefits — Centers for Medicare & Medicaid Services. Public domain U.S. government educational material, accessed October 28, 2026. Fynoptic has selected sections, removed print navigation, and reformatted the text for this guide. The agency does not endorse Fynoptic.