Beginning Jan 1, 2026, CMS is implementing a new mandatory bundling model called TEAM: Transforming Episode Accountability Model. 

The TEAM model will run from January 2026 to December 2030.

The TEAM model includes 5 mandatory bundled diagnoses:

1. Coronary Artery Bypass Graft (CABG)
2. Major Bowel Procedure
3. Lower Extremity Joint Replacement (LEJR)
4. Surgical Hip and Femur Fracture Treatment (SHFFT)
5. Spinal Fusion

There are 188 mandatory locations in 44 States, for a total of 735 mandatory participating hospitals, plus an additional 10 hospitals participating voluntarily.

This means that every Medicare patient who discharges from a participating hospital with one of the above diagnoses is included in the TEAM bundling model.

Bundling is a Medicare A payment model designed to save Medicare money by incentivizing providers to streamline processes to bring down Medicare costs.  

Hospitals can receive a Medicare reward payment when they meet certain quality measures and bring down the cost of a Medicare episode, which includes the hospitalization plus 30 days after.

What does this mean to the SNF?

• Hospitals may divert these residents to Home Health to reduce costs
• Hospitals may create financial arrangements with SNFs to incentivize them to reduce costs
• Hospitals may monitor SNF length of stay for these residents
• Hospitals will want to partner with SNFs who have optimal Quality Measure performance
• SNFs with 3+ stars may utilize the 3-Day waiver for these patients 
• CMS will post a list of eligible SNFs on the TEAM website quarterly
• Billers must put “A9” in Field 63 of the UB04: TX Auth Code to bypass the 3-day requirement

For more information on the TEAM Model: https://www.cms.gov/priorities/innovation/innovation-models/team-model

To view participating hospitals in your state: https://www.cms.gov/team-model-participant-list

If you have questions or need additional information, please email us at: Medicarequestions@enhancetherapies.com