Medicare Part B covers up to 36 pulmonary rehab sessions with a referral for moderate-to-very-severe COPD, or for confirmed or suspected COVID-19 with respiratory symptoms.Centers for Medicare & Medicaid Services. (n.d.). Pulmonary rehabilitation programs coverage - Medicare.gov. medicare.gov. Retrieved Sep 28, 2026, from https://www.medicare.gov/coverage/pulmonary-rehabilitation-programs It isn't free, though: you pay 20% of the Medicare-approved amount, plus a hospital copay if the program runs through a hospital outpatient department. Knowing that before you start beats a surprise bill.
In This Guide
- Key Takeaways
- Does Medicare Cover Pulmonary Rehab, and What's Included?
- Do You Qualify for Medicare Pulmonary Rehab?
- How Many Pulmonary Rehab Sessions Will Medicare Pay For?
- What Pulmonary Rehab Actually Costs
- Does Your Medicare Advantage Plan or Medigap Change What You Pay?
- How to Get Started
- What If You Don't Qualify?
- Frequently Asked Questions
- Learn More
Does Medicare Cover Pulmonary Rehab, and What's Included?
If your doctor refers you, you'll be enrolling in a supervised program, run in either a doctor's office or a hospital outpatient setting.Centers for Medicare & Medicaid Services. (n.d.). Pulmonary rehabilitation programs coverage - Medicare.gov. medicare.gov. Retrieved Sep 28, 2026, from https://www.medicare.gov/coverage/pulmonary-rehabilitation-programs Medicare treats it as a defined course with a start, a session count, and an end, which we'll walk through below.
Do You Qualify for Medicare Pulmonary Rehab?
Medicare doesn't open this benefit to everyone with a breathing problem. Part B covers a pulmonary rehabilitation program for two named groups, and the rule leaves room for Medicare to add other conditions later.Centers for Medicare & Medicaid Services. (n.d.). Pulmonary rehabilitation programs coverage - Medicare.gov. medicare.gov. Retrieved Sep 28, 2026, from https://www.medicare.gov/coverage/pulmonary-rehabilitation-programs
People with moderate-to-very-severe COPD. If you have chronic obstructive pulmonary disease classified as GOLD stage II, III, or IV, Medicare covers pulmonary rehab when the physician treating your chronic respiratory disease refers you for it.Centers for Medicare & Medicaid Services. (n.d.). Pulmonary rehabilitation programs coverage - Medicare.gov. medicare.gov. Retrieved Sep 28, 2026, from https://www.medicare.gov/coverage/pulmonary-rehabilitation-programs The referral piece matters: this is a doctor-ordered program, not something you sign up for on your own. Mild COPD (GOLD stage I) falls below the threshold.
People with lingering symptoms after COVID-19. Medicare added a second path in 2022. If you've had confirmed or suspected COVID-19 and you're left with persistent symptoms that include respiratory trouble for at least four weeks, you can qualify for the same pulmonary rehab benefit.Centers for Medicare & Medicaid Services. (n.d.). Pulmonary rehabilitation programs coverage - Medicare.gov. medicare.gov. Retrieved Sep 28, 2026, from https://www.medicare.gov/coverage/pulmonary-rehabilitation-programs So if long COVID has left your breathing rough a month or more after infection, it's worth asking your doctor whether pulmonary rehab applies to you.
How Many Pulmonary Rehab Sessions Will Medicare Pay For?
Medicare starts you at up to 36 sessions, no more than two 1-hour sessions a day, spread over as much as 36 weeks.Centers for Medicare & Medicaid Services. (n.d.). Pulmonary rehabilitation programs coverage - Medicare.gov. medicare.gov. Retrieved Sep 28, 2026, from https://www.medicare.gov/coverage/pulmonary-rehabilitation-programs
If you and your care team think you'd benefit from more, there's a built-in extension. Your Medicare Administrative Contractor (the regional company that processes Medicare claims) can approve an additional 36 sessions over an extended period, for up to 72 in total.Centers for Medicare & Medicaid Services. (n.d.). Pulmonary rehabilitation programs coverage - Medicare.gov. medicare.gov. Retrieved Sep 28, 2026, from https://www.medicare.gov/coverage/pulmonary-rehabilitation-programs CMS billing guidance describes one route to that second block: someone who already finished rehab for COPD and then needs it for post-COVID breathing trouble, or the other way around.Centers for Medicare & Medicaid Services. (n.d.). Pulmonary rehabilitation programs coverage - Medicare.gov. medicare.gov. Retrieved Sep 28, 2026, from https://www.medicare.gov/coverage/pulmonary-rehabilitation-programs Either way, the extra sessions past the first 36 need that contractor's sign-off rather than being automatic, so if you're getting close to 36 and still benefiting, ask the program and your doctor how they would request the extension.
What Pulmonary Rehab Actually Costs
Here's where "Medicare covers it" and "Medicare pays for all of it" part ways. Pulmonary rehab is a Part B service, and it carries the normal Part B cost-sharing. Here is how the pieces stack up in Original Medicare:Centers for Medicare & Medicaid Services. (n.d.). Pulmonary rehabilitation programs coverage - Medicare.gov. medicare.gov. Retrieved Sep 28, 2026, from https://www.medicare.gov/coverage/pulmonary-rehabilitation-programs,Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Sep 4, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
| Cost | Doctor's office | Hospital outpatient department |
|---|---|---|
| Part B deductible ($283 in 2026) | Applies | Applies |
| 20% of the Medicare-approved amount | You pay it | You pay it |
| Hospital copayment | None | You pay it every session |
First, the Part B deductible applies, so you pay the first $283 of covered Part B costs in 2026 before Medicare starts paying its share.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Sep 4, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles After that, you owe 20% of the Medicare-approved amount for the program, as long as the provider accepts assignment.Centers for Medicare & Medicaid Services. (n.d.). Pulmonary rehabilitation programs coverage - Medicare.gov. medicare.gov. Retrieved Sep 28, 2026, from https://www.medicare.gov/coverage/pulmonary-rehabilitation-programs,Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Oct 11, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
Then there's the wrinkle that depends on where you go. In a doctor's office, the 20% coinsurance is the whole story. In a hospital outpatient setting, you also pay the hospital a copayment every session, on top of the 20%.Centers for Medicare & Medicaid Services. (n.d.). Pulmonary rehabilitation programs coverage - Medicare.gov. medicare.gov. Retrieved Sep 28, 2026, from https://www.medicare.gov/coverage/pulmonary-rehabilitation-programs Medicare's general rule for hospital outpatient services is that, in most cases, the copayment for any one service can't be more than the Part A hospital deductible, which is $1,736 in 2026, though it can be higher at a critical access hospital.U.S. Government Publishing Office. (n.d.). 42 CFR 419.41 - Calculation of national beneficiary copayment amounts and national Medicare program payment amounts (eCFR, current). ecfr.gov. Retrieved Oct 15, 2026, from https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-419/subpart-D/section-419.41 That is a ceiling, not a typical price, and it repeats across a 36-session course, so ask the program up front what your per-session out-of-pocket will be.
Does Your Medicare Advantage Plan or Medigap Change What You Pay?
If you have a Medicare Advantage plan. Plans must cover the medically necessary services Original Medicare covers, but they can use provider networks and can require prior authorization (plan approval) before covering certain services.Centers for Medicare & Medicaid Services. (n.d.). Compare Original Medicare & Medicare Advantage - Medicare.gov. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage Before you book a program, call your plan, using the number on your member ID card, to confirm it's in the network and whether approval is needed.Centers for Medicare & Medicaid Services. (n.d.). Contact Medicare — Medicare.gov. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/talk-to-someone The cost-sharing above describes Original Medicare, so ask your plan what it charges.
If you have Original Medicare. A Medigap policy is extra insurance that helps pay your share of out-of-pocket costs in Original Medicare, so it may cover some of the amounts above.Centers for Medicare & Medicaid Services. (n.d.). 12026 understanding medicare advantage plans. medicare.gov. Retrieved Sep 24, 2026, from https://www.medicare.gov/publications/12026-understanding-medicare-advantage-plans.pdf What a particular policy pays depends on the plan, so check yours or ask the insurer. Medigap can't be used to pay Medicare Advantage costs.Centers for Medicare & Medicaid Services. (n.d.). 12026 understanding medicare advantage plans. medicare.gov. Retrieved Sep 24, 2026, from https://www.medicare.gov/publications/12026-understanding-medicare-advantage-plans.pdf
How to Get Started
- Talk to the doctor treating your lung condition. For COPD, that doctor's referral is what opens the benefit.Centers for Medicare & Medicaid Services. (n.d.). Pulmonary rehabilitation programs coverage - Medicare.gov. medicare.gov. Retrieved Sep 28, 2026, from https://www.medicare.gov/coverage/pulmonary-rehabilitation-programs If you had COVID-19 and are still short of breath after four weeks or more, describe your symptoms specifically.
- Find a program. Medicare covers pulmonary rehab in a doctor's office or a hospital outpatient setting that offers it, so ask your doctor where they refer patients.Centers for Medicare & Medicaid Services. (n.d.). Pulmonary rehabilitation programs coverage - Medicare.gov. medicare.gov. Retrieved Sep 28, 2026, from https://www.medicare.gov/coverage/pulmonary-rehabilitation-programs For Original Medicare coverage questions, you can also call 1-800-MEDICARE (1-800-633-4227), which has a real person on the line 24 hours a day, 7 days a week, except some federal holidays.Centers for Medicare & Medicaid Services. (n.d.). Contact Medicare — Medicare.gov. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/talk-to-someone
- Ask whether the program accepts assignment. If a provider accepts assignment, you typically pay 20% of the Medicare-approved amount; with providers who don't, you may pay more.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Oct 11, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
- Ask for your copay in writing before session one. If the program is hospital-based, find out the per-session hospital copayment and whether you have other coverage that picks it up.
- Get free, unbiased help if the paperwork is confusing. Your State Health Insurance Assistance Program (SHIP) gives free health insurance counseling to people with Medicare and their families. Find yours at shiphelp.org or call 1-877-839-2675.Centers for Medicare & Medicaid Services. (n.d.). Filing an appeal. medicare.gov. Retrieved Sep 29, 2026, from https://www.medicare.gov/providers-services/claims-appeals-complaints/appeals,Centers for Medicare & Medicaid Services. (2026). Medicare & You 2026 (CMS publication 10050, medicare.gov). medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/publications/10050-medicare-and-you.pdf
What If You Don't Qualify?
Mild COPD (GOLD stage I) falls below the threshold, and so does a breathing problem that doesn't fit either named group today.Centers for Medicare & Medicaid Services. (n.d.). Pulmonary rehabilitation programs coverage - Medicare.gov. medicare.gov. Retrieved Sep 28, 2026, from https://www.medicare.gov/coverage/pulmonary-rehabilitation-programs Two things are still worth a conversation. The regulation describes pulmonary rehab as a program for COPD and certain other chronic respiratory diseases, and says Medicare can add medical indications through a national coverage determination, so if you have another chronic lung disease, ask your doctor whether it's covered.Centers for Medicare & Medicaid Services. (n.d.). Pulmonary rehabilitation programs coverage - Medicare.gov. medicare.gov. Retrieved Sep 28, 2026, from https://www.medicare.gov/coverage/pulmonary-rehabilitation-programs And if you're told no and want a second opinion on the coverage rules, 1-800-MEDICARE and your SHIP can both answer coverage questions.Centers for Medicare & Medicaid Services. (n.d.). Contact Medicare — Medicare.gov. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/talk-to-someone,Centers for Medicare & Medicaid Services. (n.d.). Filing an appeal. medicare.gov. Retrieved Sep 29, 2026, from https://www.medicare.gov/providers-services/claims-appeals-complaints/appeals If you have Original Medicare and disagree with a decision on your Medicare Summary Notice, you can appeal: the appeal must be in writing and received within 120 days of the date you get the notice, and the notice's last page gives the steps.Centers for Medicare & Medicaid Services. (n.d.). "Medicare Summary Notice" (MSN) (Medicare.gov). medicare.gov. Retrieved Sep 27, 2026, from https://www.medicare.gov/basics/forms-publications-mailings/mailings/costs-and-coverage/medicare-summary-notice,Centers for Medicare & Medicaid Services. (n.d.). Appeals in Original Medicare. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/providers-services/claims-appeals-complaints/appeals/original-medicare
Frequently Asked Questions
Does Medicare cover pulmonary rehab for COPD?
Yes, for GOLD stage II, III, or IV (moderate to very severe) with a referral from the doctor treating your respiratory disease. Two things trip people up: stage I (mild) COPD doesn't qualify, and you can't self-enroll, since the referral is the gate.
Does Medicare cover pulmonary rehab after COVID?
Yes, thanks to a 2022 expansion that added anyone with confirmed or suspected COVID-19 and respiratory symptoms lasting four or more weeks. Because it's a newer route than the long-standing COPD one, name your lingering symptoms specifically when you talk to your doctor.
How many pulmonary rehab sessions does Medicare pay for?
Thirty-six to start (two 1-hour sessions a day, max), spread over as much as 36 weeks. If you'd benefit from more, your Medicare Administrative Contractor can approve a second block of 36, for up to 72 in total, though that second block needs their sign-off first.
How much does pulmonary rehab cost with Medicare?
Plan on three pieces: the 2026 Part B deductible ($283), then 20% of the Medicare-approved amount, plus a per-session hospital copay if your program runs through an outpatient department. Ask for the copay figure up front, since it repeats every visit. A Medigap policy may cover some of your share, depending on the plan; with a Medicare Advantage plan, ask the plan what you'd owe.
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