Under the CMS rule, a comprehensive pulmonary rehabilitation program must be a physician-supervised program that includes all of the following components: physician-prescribed exercise, education or training, psychosocial assessment, outcomes assessment, and an individualized treatment plan. Each session must include physician-prescribed and supervised physical activity including aerobic exercise. These rules for coverage require that a comprehensive pulmonary rehabilitation program may be offered in a physician’s office (POS 11) or hospital outpatient department (POS 22). In these settings, cardiopulmonary resuscitation equipment, including a defibrillator, oxygen, and other equipment, must be available. A supervising physician (not necessarily the medical director) must be immediately available and accessible for medical consultation and emergencies while the rehabilitation services are being performed. The supervising physician’s duties may be shared by multiple physicians, but one physician must be designated as the supervising physician for each scheduled session of service. For comprehensive pulmonary rehabilitation that is provided in a hospital outpatient department or a physician’s office, the supervising physician must be physically present but not necessarily in the same room, interruptible and immediately available to furnish assistance and direction throughout the performance of the rehabilitation program. Nonphysician practitioners (eg, physician’s assistants, nurse practitioners) are currently prohibited from providing such supervision by CMS in either setting. Staff may include nurses, respiratory therapists, and other trained professionals authorized to perform services in accordance with state and local laws.