ED Coding & Reimbursement Alert - 2020 Issue 5
Industry Note: Feds Extend Joint Replacement Bundling Demo for 3 More Years
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Article Overview
This article summarizes a CMS proposed rule affecting the Comprehensive Care for Joint Replacement (CJR) Model and explains the broad policy changes under consideration for the demonstration. It is relevant for hospital and orthopedic revenue cycle staff, coders, and Medicare payment professionals who track bundled payment programs and CMS rulemaking.
Why This Topic Matters
Bundled payment demonstrations can affect Medicare reimbursement, episode-based financial reconciliation, and operational planning for hospitals and surgical providers. This note highlights proposed program timing and methodology changes that could affect organizations participating in joint replacement payment initiatives.
What You Will Learn
- What CMS proposed for the CJR Model extension
- What aspects of the model’s reconciliation timing are being revised
- What broad types of episode-level payment adjustments are being modified
- Which federal rulemaking source announced the proposed changes
Who Should Read This
- Hospital coders
- Orthopedic coding and billing staff
- Medicare reimbursement specialists
- Revenue cycle professionals
- Compliance staff
- Healthcare administrators
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