CMS Plans to Add Outpatient HipKnee Replacements to CJR Model, Seeks Comments on ASC Joint Procedure Bundled Payment Model

Lexology March 5, 2020
Reed Smith LLP

The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule that would extend and modify the Comprehensive Care for Joint Replacement (CJR) Model, under which CMS makes a “bundled” payment to participant hospitals for an “episode of care” for lower extremity joint replacement (LEJR) surgery, covering all services provided during the inpatient admission through 90 days post-discharge (with certain exceptions). Notably, CMS has proposed incorporating outpatient hip and knee replacements into the episode of care definition, now that these procedures are no longer on the CMS “inpatient only” list. CMS also requests comments on a potential future bundled payment model focusing on LEJR procedures performed in ambulatory surgical centers (ASCs). CMS will accept comments on until April...

Today's Sponsors

Today's Sponsor