CHA has prepared an executive summary highlighting key provisions of the recently finalized Medicare radiation oncology model, which begins on Jan. 1, 2021. The model provides a site-neutral, prospective, bundled-episode payment for clinician and facility services furnished during a course of radiation therapy services for certain cancer types.
Participation in the radiation oncology model is mandatory for hospital outpatient departments, freestanding radiation centers, and physician group practices in certain randomly-selected ZIP codes in California.
The executive summary provides a high-level overview of the model’s participation requirements and payment methodology. A more detailed summary, prepared by Health Policy Alternatives, is available for CHA members. This summary details the Centers for Medicare & Medicaid Services specialty care models final rule, which also implements the end-stage renal disease treatment choices model, which is also a mandatory in certain geographic areas and begins on Jan. 1.