CMS is expanding its Comprehensive Care for Joint Replacement (CJR) Model and plans to make the updated payment model mandatory for hospitals, starting Oct. 1, 2027.  
 
Announced April 10, 2026, the Comprehensive Care for Joint Replacement Expanded (CJR-X) model would make participating hospitals responses for care and spending for lower extremity joint replacements such as hip, knee and ankle replacements. 
 
Each episode of CJR-X, which will utilize a risk adjustment methodology, will follow the patient through the first 90 days of recovery and will include physical therapy and at-home rehabilitation with boosting care coordination and quality of care while mitigating costs. 
 
To learn more about the CJR-X model, visit https://www.cms.gov/priorities/innovation/innovation-models/cjr-x.