Cardiac Rehab Connections to Peripheral Artery Disease

A free tool kit on delivering Supervised Exercise Training for PAD, “Healthy Steps for Peripheral Artery Disease” has been made available for this purpose and can be accessed through the AACVPR website (PDF download).

Video Transcript

Hello, I am Robin Wedell from Heart Fit for Life, and I’d like to welcome you to today’s topic, PAD: Cardiac Rehab Connections.

In 2017, the Centers for Medicare and Medicaid (CMS), agreed to reimbursement for Supervised Exercise Training (SET) for individuals with claudication due to Peripheral Arterial Disease (PAD).

The decision from CMS is based on significant evidence demonstrating the benefits of SET that include improved functional capacity, longer pain-free exercise times, and improved quality of life.

CMS coverage includes up to 36 SET sessions over a 12-week period. The following components of SET must be met:

Sessions last 30-60 minutes comprising a therapeutic exercise-training program for PAD in patients with claudication

Be conducted in a hospital outpatient setting, or a physicians’ office

Be delivered by qualified personnel necessary to ensure benefits exceed harms and who are trained in exercise therapy for PAD, and

Be under the direct supervision of a physician, physician assistant or nurse practitioner/clinical nurse specialist who must be trained in both basic and advanced life support techniques.

A face-to-face visit with the physician responsible for PAD treatment is required so that the patient may obtain the referral for SET.

This visit must also include information regarding cardiovascular disease and PAD risk factor reduction, which should include education counseling, behavioral interventions, or outcome assessments.

SET programs for individuals with claudication can easily be incorporated into Cardiac Rehabilitation programs. Cardiac rehab facilities have the exercise equipment necessary for SET including treadmills and arm ergometers.

Cardiac rehabilitation nurses have the knowledge and tools to monitor PAD patients to ensure the safety and effectiveness of exercise training. In addition, these nurses are able to provide risk factor assessment and education including smoking cessation, cholesterol and blood pressure management, heart-healthy eating and home exercise.

Cardiac rehabilitation staff can obtain the training required by CMS to deliver SET for PAD through AACVPR. A free tool kit, “Healthy Steps for Peripheral Artery Disease” has been made available for this purpose and can be accessed through the AACVPR website (PDF download).

The Healthy Step toolkit will provide cardiac rehab professionals with everything they need to set up PAD SET programming including medical clearance for PAD exercise, pre-exercise evaluation, how to design a PAD exercise program and outcome evaluation.

PCNA has additional resources available regarding PAD patient assessment, how to perform an ABI (ankle-brachial index) and home exercise guidelines for patients with intermittent claudication. Find these resources at

With the assistance of the staff and resources of cardiac rehabilitation programs, patients with PAD can feel better, improve their ability to walk and exercise without pain for longer periods of time, and have improved quality of life.

Thank you for all you do with patients with PAD, and for joining us today.

Funded through a grant from Janssen Pharmaceuticals, Inc.

Disclaimer: Please be aware that these forms include a sample of current clinical guidelines. However, clinical guidelines (federal, state, local, or those issued by clinical organizations) change over time, so the reader should remember to investigate any recent legal or clinical developments.