What is the level of evidence substantiating commercial payers coverage policies for total joint arthroplasty?

The prevalence of total joint arthroplasty (TJA) in the United States has drawn the attention of healthcare stakeholders. The payers have also utilized a variety of strategies to regulate the medical necessity of these procedures. The purpose of this study was to examine the level-of-evidence (LOE) of the coverage policies being utilized by commercial payers in the United States.

Source: The Journal of Arthroplasty - March 21, 2021 Category: Orthopaedics Authors: Matthew S. Austin, Blair S. Ashley, Nicholas A. Bedard, Hari P. Bezwada, Charles P. Hannon, Yale A. Fillingham, Yogesh V. Kolwadkar, Harold W. Rees, Matthew J. Grosso, Erik N. Zeegen Source Type: research