The RO Model is a mandatory model that tests whether changing the way RT services are currently paid – via fee-for-service payments – to prospective, site neutral, modality agnostic, episode-based payments incentivizes physicians to deliver higher-value RT care. The report (PDF) identified three key reasons why RT is ready for payment and service delivery reform: the lack of site neutrality for payments incentives that encourage volume of services over the value of services and coding and payment challenges. The report was published in November 2017. In December 2015, Congress passed the Patient Access and Medicare Protection Act, which required the Secretary of Health and Human Services to submit to Congress a report on “the development of an episodic alternative payment model” for RT services. Since 2014, CMS has explored potential ways to test an episode-based payment model for RT services. CMS ha s addressed this delay through notice and comment rulemaking in the CY 2022 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule (CMS-1753-F). 133) enacted on Decemincludes a provision that prohibits implementation of the RO Model prior to January 1, 2022.

The Consolidated Appropriations Act, 2021 (H.R. The RO Model tests whether prospective, site neutral, modality agnostic, episode-based payments to physician group practices (PGPs), hospital outpatient departments (HOPD), and freestanding radiation therapy centers for RT episodes of care reduces Medicare expenditures while preserving or enhancing the quality of care for Medicare beneficiaries. The Radiation Oncology (RO) Model aims to improve the quality of care for cancer patients receiving radiotherapy (RT) and move toward a simplified and predictable payment system.

Cms mus2 oct 2015 update