Radiation Oncology Model Delayed Until July 1, 2021

October 22, 2020

On October 21, 2020, the Centers for Medicare & Medicaid Services (CMS) announced plans to delay the start date of the Radiation Oncology (RO) model until July 1, 2021. The change comes following stakeholder concerns—the Association for Clinical Oncology (ASCO) among them—about the challenges of implementing the model by the initial start date, January 1, 2021, during the COVID-19 pandemic.

The RO model is a mandatory payment model that requires participation from radiotherapy (RT) providers and suppliers that furnish RT services within randomly selected core-based statistical areas (CBSAs)—which are linked to ZIP codes. The selected CBSAs contain approximately 30% of all eligible Medicare fee-for-service (FFS) radiotherapy episodes nationwide. Model participants would receive prospective, site-neutral, modality agnostic, episode-based payments for included RT services furnished during a 90-day episode of care, instead of regular Medicare FFS payments.

ASCO thanks CMS for listening to the Association and the other stakeholder groups that urged the agency to delay the RO model until at least July of 2021. ASCO will continue to monitor implementation of the model and work with CMS to ensure appropriate reimbursement for RT services.

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