ICD10monitor June 3, 2024
Rose T. Dunn, MBA, RHIA, CPA, FACHE, FHFMA, CHPS, AHIMA-approved ICD-10-CM/PCS Trainer

The Centers for Medicare & Medicaid Services (CMS) has proposed an episodic payment model, the Transforming Episode Accountability Model (TEAM). This is one of CMS’s “innovation” models. If it makes it through the rulemaking process, the proposed model would launch on Jan. 1, 2026 and run for five years, ending on Dec. 31, 2030.

The model would be mandatory for five types of surgical procedures:

  • Lower extremity joint replacement;
  • Surgical hip femur fracture treatment;
  • Spinal fusion;
  • Coronary artery bypass graft; and
  • Major bowel procedures.

These procedures would “initiate” the episode.

For my readers, episodic payment models have been in the making since 1988. However, it has only been the last two decades that CMS has introduced and expanded...

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