Two recent studies show that hip and knee surgeons are performing more work prior to the procedure to optimize patients and achieve better outcomes.

Despite the demonstrable benefits of this approach to patient care, the standard Medicare payment system is not aligned and does not incentivize physicians to operate in this manner. In setting payment levels through the American Medical Association RVS Update Committee (RUC) process, Medicare only recognizes work performed during a period that begins on the day before surgery. There also is no appropriate CPT code to bill for preoptimization care as provided by total joint arthroplasty surgeons or others on the care team. AAHKS is working to remedy this through our advocacy efforts at the RUC with the Centers for Medicare and Medicaid Services and in Congress.