Medicare National Coverage Determinations (NCD) Manual (Pub. 100-03), Ch. 1 § 20.31.3
Benson-Henry Institute Cardiac Wellness Program (Effective
20.31.3 – Benson-Henry Institute Cardiac Wellness Program (Effective
May 6, 2014)
(Rev. 175, Issued: 10-03-14, Effective: 05-06-14, Implementation: 11-04-14)
General
The fundamental concepts of the Benson-Henry Institute Cardiac Wellness Program were
developed by Herbert Benson, MD, over 40 years ago. Benson states that “in the middle
1960s, when I noticed that people’s blood pressures were higher during visits to my
office than at other times and wondered whether stress wasn’t causing that rise. Stress
wasn’t on the radar then, so I began investigating a connection between stress and
hypertension.” (http://www.ideafit.com/fitness-library/mind-body-medicine-balanced-
approach) The Cardiac Wellness Program is a multi-component intervention program
that includes supervised exercise, behavioral interventions, and counseling, and is
designed to reduce cardiovascular risk and improve health outcomes.
B.
Nationally Covered Indications
Effective for claims with dates of service on and after May 6, 2014, the Benson-Henry
Institute Cardiac Wellness Program meets the Intensive Cardiac Rehabilitation (ICR)
program requirements set forth by Congress in §1861(eee)(4)(A) of the Social Security
Act, and in regulations at 42 C.F.R. §410.49(c) and, as such, has been included on the list
of approved ICR programs available at http://www.cms.gov/Medicare/Medicare-General-
Information/MedicareApprovedFacilitie/.
C.
Nationally Non-Covered Indications
Effective May 6, 2014, if a specific ICR program is not included on the above-noted list
as a Medicare-approved ICR program, it is non-covered.
D.
Other
N/A
(This NCD last reviewed May 6, 2014.)