If you qualify for coverage, Medicare Part B pays 80% of the costs for outpatient pulmonary rehabilitation. You may also have a copay.

Pulmonary rehab can be used for a variety of medical conditions, but Medicare Part B covers most of the costs only if you have moderate to severe chronic obstructive pulmonary disease (COPD).

Part B may also cover pulmonary rehab if you have confirmed or suspected COVID-19 and experience symptoms, including respiratory dysfunction, for at least 4 weeks.

Pulmonary rehab is a broad-based outpatient program that combines education with exercises and peer support. During pulmonary rehab, you learn more about COPD and lung function. You also learn exercises to help you gain strength and breathe more efficiently.

Peer support is a significant part of pulmonary rehab. Participating in group classes allows you to connect with and learn from others who share your condition.

A pulmonary rehabilitation program can make a big difference in the quality of life of people with COPD. Read on to learn about what Medicare covers, how to qualify for coverage, and more.

Medicare typically covers up to 36 pulmonary rehab sessions. However, your doctor may be able to request coverage for up to 72 sessions if they are deemed medically necessary for your care.

This coverage for outpatient pulmonary rehabilitation services comes through Medicare Part B. To be eligible, you must have a referral from the doctor treating your COPD. You can access pulmonary rehab services in your doctor’s office, freestanding clinic, or hospital outpatient facility.

Note that if you have a Medicare Advantage (Medicare Part C) plan, your coverage for pulmonary rehab will be at least equal to what you would get with Original Medicare. However, your costs may be different, depending on the plan you have. You may also be required to use specific doctors or facilities within your plan’s network.

To be eligible for coverage of pulmonary rehab, you must first be enrolled in Original Medicare (parts A and B) and be up to date on your premium payments. You may also be enrolled in a Medicare Advantage (Part C) plan.

The doctor who is treating you for COPD must refer you for pulmonary rehab and state that these services are necessary to treat your condition.

To gauge how severe your COPD is, your doctor will determine your GOLD (Global Initiative for Chronic Obstructive Lung Disease) stage. The COPD GOLD staging levels are:

  • stage 1 (very mild)
  • stage 2 (moderate)
  • stage 3 (severe)
  • stage 4 (very severe)

Medicare considers you eligible for pulmonary rehab if your COPD is stage 2 through stage 4.

Tip

To receive maximum coverage, make sure your doctor and the rehab facility accept Medicare. This tool can help you find a Medicare-approved doctor or facility near you.

According to a 2020 study, pulmonary rehabilitation has a base cost of around $163 a week. Your actual out-of-pocket cost with Medicare depends on your specific coverage.

Medicare Part B

With Medicare Part B in 2025, most people will pay an annual deductible of $257 and a monthly premium starting at $185.

Once you’ve met the Part B deductible, you are only responsible for 20% of the Medicare-approved costs for your pulmonary rehab. Services you receive in a hospital outpatient setting may also require a copayment to the hospital for each rehab session you attend.

Sometimes, a doctor may recommend that you have more rehab sessions than Medicare is willing to pay for. If so, you may incur the entire cost of the extra sessions.

Medicare Part C

If you have a Medicare Advantage plan, your rates for deductibles, copays, and premiums may be different. Contact your plan directly to determine how much you will be billed for these services so you aren’t surprised later.

Medigap

Medigap (Medicare supplement) plans may cover some out-of-pocket costs from Original Medicare. If you have a chronic condition, Medigap may be beneficial to keep your out-of-pocket costs down. You can compare Medigap plans to find the best for your situation.

Pulmonary rehab has many benefits. It can help you manage your respiratory symptoms and make lifestyle changes to reduce your symptoms or possibly slow disease progression.

These rehab programs are meant to improve the quality of life and independence of those living with COPD.

COPD is a group of chronic, progressive lung diseases. The most common diseases that fall under COPD include chronic bronchitis and emphysema.

Pulmonary rehabilitation may also benefit people who have respiratory dysfunction due to COVID-19.

These rehab programs are required to provide individualized, evidence-based, multidisciplinary support that includes:

  • a physician-prescribed, supervised exercise regimen
  • an individualized treatment plan
  • education and training on symptom management, medications, and use of oxygen
  • a psychosocial assessment
  • an outcomes assessment

Some pulmonary rehab programs may also include:

  • personalized nutritional guidance
  • help with stress management
  • a smoking cessation program
  • peer support and interaction with other participants

Rehab can allow you to meet and connect with other people who are managing COPD. This type of support system can be invaluable.

Pulmonary rehab can be highly beneficial for people with COPD and people with respiratory dysfunction due to COVID-19. It provides individualized education, support, and techniques for managing symptoms.

If a Medicare-approved doctor provides you with the necessary referral for pulmonary rehab sessions, you’ll be covered.

Remember that costs can vary based on the type of Medicare plan you have.