Radiation Oncology Model Episodes of Care: Analyzing Medicare Spending

Monday, September 30, 2019 | by Randy Haught

Tags: CMS Mandatory Payment Model, Radiation Oncology

On July 18, 2019, the Centers for Medicare and Medicaid Services (CMS) proposed a payment model that would make prospective episode payments to hospital outpatient departments (HOPD) and freestanding radiation therapy centers for radiation therapy (RT) episodes of care. The model will be mandatory for a sample of RT providers and suppliers and is specific to core-based statistical area (CBSAs), which have not yet been determined. Medicare would pay participating providers and suppliers a site-neutral, episode-based payment for a list of specified professional and technical RT services furnished during a 90-day episode to Medicare fee-for-service (FFS) beneficiaries diagnosed with one of 17 cancer types. This blog is the first in the multi-series of blogs titled "Radiation Oncology Episodes of Care" and takes a look the historical Medicare payments for radiation therapy.