As far as my interpretation, as long as "some aerobic exercise must be included in each pulmonary rehab session". For example if you do 30 of aerobic exercise and 30 of education, you can bill for 1 hour of pulm rehab. So If my patients are coming for 30 minutes of one to one OT and 30 minutes one to one PT, then 75 minutes of group exercise and 45 education, I bill for 2 PR sessions.