Mandatory CMS payment model · Begins January 1, 2028
CJR-X: Readiness Starts With Reliable PROMs
CJR-X brings financial accountability to eligible hip, knee and inpatient ankle replacement episodes, with hip and knee patient-reported outcomes contributing to its quality assessment. CODE Technology manages PROMs collection, reporting preparation and benchmarking—including surveys for hip, knee and ankle patients—to help your team measure outcomes and prepare for the model’s January 2028 start.
CJR-X At A Glance
What CJR-X means for hospitals
CJR-X connects financial performance to the quality and total cost of care across the full joint-replacement episode, not just the procedure.
Mandatory nationwide
Begins January 1, 2028 for acute care hospitals, with CMS-defined exclusions including Maryland hospitals and TEAM participants.
Inpatient and outpatient
Qualifying lower-extremity joint replacements are included whether performed inpatient or in the hospital outpatient setting.
90-day episodes
Accountability runs from the qualifying procedure through 90 days after discharge, well beyond the hospital stay.
Quality gates payment
A Composite Quality Score, which includes the THA/TKA PRO-PM, affects eligibility for reconciliation payments/
For a closer look at the model and its timeline, read CJR-X: What Hospitals Need to Know.
Inpatient or outpatient, the clock is already running.
Under CJR-X, PRO-PM results feed the score tied to reconciliation payments. And a missed pre-operative survey can never be collected after surgery.
2024
Inpatient PRO-PM becomes mandatory
Hospital IQR reporting of the THA/TKA PRO-PM moves past voluntary periods.
October 2027
Outpatient pre-op collection starts
Baseline surveys for 2028 outpatient procedures must be captured before surgery.
January 1, 2028
CJR-X launches
Outpatient PRO-PM mandatory reporting also begins with CY 2028 procedures.
What CJR-X changes, and what CODE does about it
CODE already runs fully-managed hip and knee PRO programs. Here’s how that service lines up with what CJR-X asks of your hospital.
| What CJR-X changes | How CODE handles it |
|---|---|
| PRO-PM results affect payment The THA/TKA PRO-PM is one of five measures in the Composite Quality Score. | A CMS-focused dashboard shows each PRO-PM’s status, so capture gaps are visible before they count against you. |
| Outpatient episodes count Outpatient joint replacements are in CJR-X, and outpatient PRO-PM reporting becomes mandatory for 2028 procedures. | One program enrolls inpatient and outpatient THA/TKA patients, so you don’t run two collection processes. |
| Pre-op baselines can’t be recovered Surveys missed before surgery can’t be collected afterward. | Automated enrollment captures eligible patients and the CMS-required fields up front, before surgery. |
| Post-op surveys come a year later Follow-up surveys fall many months after the procedure, long after patients have left your care. | A dedicated U.S.-based call team handles follow-up through the one-year mark by email, text and phone |
| Quality is scored against national performance How your outcomes compare matters, not just whether you reported them. | Benchmarking against CODE’s orthopedic registry, built over 10+ years, shows where you stand. |
| CMS rules keep evolving CJR-X specifications and participant lists will be updated before and after launch. | Clinically trained experts track CMS requirements, so your program adjusts without your team re-learning the rules. |
New to fully-managed PROMs? See how the full program works.
Get an estimate of your PROMs staffing savings and ROI with a fully-managed approach.
Where you start depends on where you are today
ALREADY A CODE CLIENT
Extend your THA/TKA program to CJR-X.
Your account manager will confirm your participant status, check whether outpatient procedures are enrolled and review how your PRO-PM performance positions you for the Composite Quality Score.
USing another vendor or doing it in-house
Switch before the 2027 collection window.
With go-live about 30 days after kickoff, there is still time to have outpatient collection running before pre-op surveys for 2028 procedures begin.
Six questions to answer before 2028
If any of these are hard to answer, a readiness review is a good next step.
CJR-X planning resources
UNDERSTAND THE MODEL
CJR-X: What Hospitals Need to Know
The model, its timeline and the role of patient-reported outcomes.
PLAN YOUR APPROACH
Q&A with Bundled Payment Expert Matt Civili
Explore insights on managing episode costs, post-acute care, and physician gain-sharing.
CHECK YOUR STATUS
CJR-X Participant Directory
Search the current CMS participant list by hospital name, state or CCN.
Be ready before CJR-X begins.
In a CJR-X readiness review, we’ll confirm your participant status, check inpatient and outpatient PRO coverage and map what needs to be in place before late 2027.