Bridging the Coverage Gap
- 1Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- 2College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- 3Division of Cardiovascular Medicine, Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
Abstract
Background: Cardiac rehabilitation (CR) is a guideline-supported, evidence-based intervention that improves cardiovascular outcomes, yet access remains inconsistent for Medicaid beneficiaries because coverage policies vary across states.
Project Rationale: We evaluated Medicaid reimbursement for outpatient CR services across all 50 U.S. states to identify policy variation that may contribute to inequitable access for vulnerable populations.
Project Summary: A cross-sectional survey review of state Medicaid fee schedules, provider manuals, coverage policies, and direct communication with Medicaid agencies assessed reimbursement for Current Procedural Terminology codes 93797 and 93798. Most states provided coverage, but important geographic variation remained, with several states lacking reimbursement for one or both services. Limited coverage frequently occurred in regions with large Medicaid populations, potentially restricting access to guideline-supported cardiovascular care.
Take-Home Messages: State Medicaid reimbursement policies remain an important determinant of access to outpatient CR. Greater policy consistency may reduce disparities and improve equitable delivery of evidence-based cardiovascular care.
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BibTeX
@article{henson2026bridging,
title = {{Bridging the Coverage Gap}},
author = {J. Curran Henson and Garrett S. Spears and Brett K. Daughdrill and Joshua N. Hagood and Srikanth Vallurupalli},
journal = {JACC Case Reports},
year = {2026},
month = sep,
doi = {10.1016/j.jaccas.2026.110187},
url = {https://doi.org/10.1016/j.jaccas.2026.110187},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Bridging the Coverage Gap
AU - J. Curran Henson
AU - Garrett S. Spears
AU - Brett K. Daughdrill
AU - Joshua N. Hagood
AU - Srikanth Vallurupalli
PY - 2026
DA - 2026/09/16
JO - JACC Case Reports
DO - 10.1016/j.jaccas.2026.110187
UR - https://doi.org/10.1016/j.jaccas.2026.110187
AB - Background: Cardiac rehabilitation (CR) is a guideline-supported, evidence-based intervention that improves cardiovascular outcomes, yet access remains inconsistent for Medicaid beneficiaries because coverage policies vary across states. Project Rationale: We evaluated Medicaid reimbursement for outpatient CR services across all 50 U.S. states to identify policy variation that may contribute to inequitable access for vulnerable populations. Project Summary: A cross-sectional survey review of state Medicaid fee schedules, provider manuals, coverage policies, and direct communication with Medicaid agencies assessed reimbursement for Current Procedural Terminology codes 93797 and 93798. Most states provided coverage, but important geographic variation remained, with several states lacking reimbursement for one or both services. Limited coverage frequently occurred in regions with large Medicaid populations, potentially restricting access to guideline-supported cardiovascular care. Take-Home Messages: State Medicaid reimbursement policies remain an important determinant of access to outpatient CR. Greater policy consistency may reduce disparities and improve equitable delivery of evidence-based cardiovascular care.
SN - 2666-0849
ER -