GroundRules
42 CFR 510.100: Episodes being tested.
Where this section sits in the code
- Title 42—Public Health
- CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES
- SUBCHAPTER H—HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS
- PART 510—COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL
- Subpart B—Comprehensive Care for Joint Replacement Program Participants
(a) Initiation of an episode. An episode is initiated when, with respect to a beneficiary described in § 510.205—
(1) The participant hospital admits the beneficiary for an anchor hospitalization; or
(2) On or after July 4, 2021, an anchor procedure is performed at the participant hospital.
(b) Exclusions. A hospital is excluded from being a participant hospital, but only so long as any of the following conditions apply:
(1) The hospital is an episode initiator for an LEJR episode in the risk-bearing period of Models 2 or 4 of BPCI.
(2) The hospital is participating in Model 1 of BPCI.
(3) These exclusions cease to apply as of the date that the hospital no longer meets any of the conditions specified in this paragraph.
Collected 2026-08-27T02:26:11Z. Source file · JSON