the Centers for Medicare & Medicaid Services (CMS) displayed the CY 2022 Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems (OPPS/ASC) Notice of Proposed Rulemaking (CMS-1753-P), which includes proposals related to the Radiation Oncology (RO) Model.

Getty Images


July 21, 2021 — On July 19, 2021, the Centers for Medicare & Medicaid Services (CMS) displayed the CY 2022 Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems (OPPS/ASC) Notice of Proposed Rulemaking (CMS-1753-P), which includes proposals related to the Radiation Oncology (RO) Model.

The RO Model tests whether prospective, site neutral, modality agnostic, episode-based payments to physician group practices (including freestanding radiation therapy centers), and hospital outpatient departments for radiotherapy (RT) episodes of care reduces Medicare expenditures while preserving or enhancing the quality of care for Medicare beneficiaries.

The RO Model has a new proposed start date of January 1, 2022, and would run for 5 performance years, ending December 31, 2026. The proposed rule also includes the following proposals:

  • Adjusting the pricing methodology, including updating the baseline period to 2017-2019 and lowering the discounts to 3.5 and 4.5 percent, for the professional component and technical component, respectively.
  • Removing brachytherapy from the included modalities.
  • Proposing that in cases where a beneficiary switches from traditional FFS to Medicare Advantage during an episode before treatment is complete, we would consider this an incomplete episode and RT services will be paid FFS as opposed to the bundled payment.
  • In light of the current PHE and several recent natural disasters, adding an extreme and uncontrollable circumstances policy. This policy would give flexibility to reduce administrative burden of Model participation, including reporting requirements, and/or adjust the payment methodology as necessary.
  • Modifying the current overlap policy for the Pennsylvania Rural Health Model (PARHM) to only exclude hospitals participating in PARHM, not just PARHM-eligible hospitals, and adding an overlap policy for the Community Track of the CHART Model. The RO Model would follow the same policy for overlap between the RO Model and the Medicare Shared Savings Program ACOs for the CHART ACO Transformation Track.

In addition to these proposals, CMS is removing liver cancer from the RO Model. CMS also includes clarifications in the NPRM to help address questions from stakeholders and future RO participants related to the interaction between the RO Model and the Quality Payment Program. 

CMS is seeking comment on these proposals.

For more information, reference the RO Model: https://innovation.cms.gov/innovation-models/radiation-oncology-model

For questions on the RO Model or for RO participants seeking to attain their RO Model ID: [email protected]

Related RO Model content:

ASTRO Responds to Troubling Medicare Cuts, Radiation Oncology Model Update


Related Content

News | Radiation Oncology

June 5, 2023 — Volpara Health Technologies Ltd. announces its founding membership in CancerX, a public-private ...

Time June 05, 2023
arrow
News | Linear Accelerators

June 5, 2023 — UMC Utrecht researchers in the Netherlands are starting two new projects to treat cancer with image ...

Time June 05, 2023
arrow
Feature | Radiology Imaging | By Melinda Taschetta-Millane

It's been a fruitful month for itnonline.com! Here's a look at what ITN viewers found to be most interesting during the ...

Time June 01, 2023
arrow
News | Radiation Oncology

May 31, 2023 — Elekta announced the launch of the first phase of Elekta ONE*, its most comprehensive and advanced ...

Time May 31, 2023
arrow
News | Radiation Therapy

May 30, 2023 — The first treatment, for a patient with prostate cancer, was successfully carried out on April 28. Yonsei ...

Time May 30, 2023
arrow
News | Oncology Information Management Systems (OIMS)

May 24, 2023 — RaySearch Laboratories AB announced that the oncology information system RayCare* (* subject to ...

Time May 24, 2023
arrow
News | ASTRO

May 23, 2023 — More than 9 in 10 radiation oncologists report that their practices face clinical staff shortages ...

Time May 23, 2023
arrow
News | Radiation Oncology

May 23, 2023 — ZAP Surgical Systems, Inc., a leading innovator in the field of surgical robotics, today announced that ...

Time May 23, 2023
arrow
News | Radiation Oncology

May 22, 2023 — Physicians and scientists from the UCLA Jonsson Comprehensive Cancer Center will discuss the latest ...

Time May 22, 2023
arrow
News | Radiation Oncology

May 18, 2023 — Cassling announced it is a new strategic sales agent in various geographic territories across the United ...

Time May 18, 2023
arrow
Subscribe Now