Most common
Traditional Medicare
Covered nationally, CMS NCD 20.20
- Part B benefit (no Part A inpatient stay required)
- Medigap supplements absorb the 20% coinsurance
- Same coverage at every Flow Therapy location
EECP has been Medicare-approved since 1999 (CMS NCD 20.20). For most of our patients with traditional Medicare and a Medigap supplement, the full 35-session course costs nothing out of pocket. We verify your coverage before you start, never after.
Medicare and most major insurers cover the entire FDA-cleared course of EECP for qualifying diagnoses. Here’s what that means in practice.
Medicare covers EECP for these conditions when the criteria below are met.
For most patients with Medicare + a Medigap (supplement) plan:
Medicare pays 80% of the approved amount; Medigap covers the remaining 20%. Patients without a Medigap supplement are responsible for that 20% coinsurance, we’ll tell you exactly what that comes to before you start.
We’re in-network with every major Medicare administrator and most commercial carriers across Texas, North Carolina, and Georgia. Don’t see your plan? Ask, we add new contracts quarterly.
Covered nationally, CMS NCD 20.20
Plan-dependent, verified per patient
In-network with most major Texas & NC carriers
Accepted with referral / authorization
We’ve run insurance for over 50,000 patients. The process is simple, fast, and never costs you anything to find out.
Either upload it through the consultation form or bring it to a clinic. We need the front and back, that’s all.
Our intake team contacts your plan directly and confirms three things: (1) EECP is a covered benefit, (2) what your deductible and coinsurance are, and (3) whether prior authorization is needed. This typically takes 1-3 business days.
Before you ever sit on the table, you receive a written cost breakdown, what insurance covers, what (if anything) you’ll owe, and how billing works through the course. No verbal promises that change later.
Some Medicare Advantage and commercial plans require prior authorization for EECP. We submit the documentation (your cardiologist’s referral, diagnosis codes, medical necessity letter) and follow up with the carrier, you don’t have to.
If your plan denies EECP or you’re uninsured, we’ll tell you immediately and walk you through self-pay options. The 35-session course at our self-pay rate is a fraction of what stent or CABG procedures cost out of pocket.
Share your details and our intake team will check your benefits, then call you back, usually within one business day.
Most Medicare Advantage plans cover EECP under the same CMS guidelines as traditional Medicare. The catch is that MA plans often require prior authorization, which we handle for you. Out-of-pocket cost depends on your specific plan’s copay/coinsurance structure, we verify yours specifically before you start. We work with all major MA carriers including Humana, UnitedHealthcare, Aetna, Cigna, and Blue Cross.
Medicare’s approved amount for EECP varies slightly by region, but your 20% coinsurance for the full 35-session course typically comes to a few hundred to around a thousand dollars total, significantly less than most patients expect. We give you the exact number in writing before you commit. Some patients pay in installments across the course; ask your coordinator about payment plans.
We offer self-pay rates for patients without coverage. For perspective: the full 35-session EECP course at self-pay is a fraction of the cost of a single stent procedure or CABG (often $40K-$100K+). If your plan denies coverage, we can also help you appeal, we have decades of experience getting denials overturned with the right documentation.
Medicare and most insurers require a referral or order from a cardiologist or primary care physician documenting the qualifying diagnosis (angina, CAD, persistent chest pain). If you don’t have one, we can help coordinate with your existing physician, or our medical director can do an initial consult to determine whether EECP is appropriate. The referral is paperwork, not a barrier.
Typically 1-3 business days from when we receive your insurance card. Plans requiring prior authorization can take 5-10 business days depending on the carrier’s turnaround. Either way, we communicate status the whole way through, you’re never wondering where things stand. We don’t start treatment until verification is complete and you’ve reviewed the written estimate.
No, billing happens per session, not as a lump-sum course fee. If you need to stop early for a medical or personal reason, you’re only responsible for the sessions you actually received (and your insurance only pays for those sessions). We always encourage completing the full 35-hour protocol for clinical reasons, but the financial arrangement is flexible.
No surgery talk. No commitment. Just answers from the team that has helped 50,000+ patients regain energy, walk further, and feel like themselves again.