Musculoskeletal Surgery (MSK)
Provider Tools
Clinical guidelines can be accessed below. For health plan specific clinical guidelines, CMS guidelines and Local Coverage Determinations (LCDs), educational documents and other information, please log into RadMD.
Clinical Guideline
Musculoskeletal Surgery Guidelines
Place of Service Policy for Musculoskeletal Surgery
The Place of Service guideline displayed on this page reflects Evolent’s general policy and is provided for reference only. It is not necessarily the standard that will be applied in any particular instance, as the actual criteria applied will depend on the member’s specific benefit plan, the health plan’s definition of medical necessity, relevant evidence-based clinical guidelines, plan-specific guidance, and any applicable regulatory standards. In the event of any conflict between this policy and a health plan’s specific guidance or applicable regulation, the health plan-specific guideline or regulation will always take precedence. Providers should always consult the applicable health plan’s specific Site of Care guidance.
Musculoskeletal Documents
Treatment Plan Checklists
Musculoskeletal Clinical Tip Sheets
- Hip and Knee Arthroplasty Clinical Tip Sheet (Commercial)
- Hip and Knee Arthroplasty Clinical Tip Sheet (Medicare)
- Knee Arthroscopy Clinical Tip Sheet
- Shoulder Arthroplasty Clinical Tip Sheet
- Shoulder Arthroscopy Clinical Tip Sheet