Title 42

PART 512 SUBPART B

Subpart B - Radiation Oncology Model

• 42 U.S.C. 1302, 1315a, and 1395hh.
• 85 FR 61362, Sept. 29, 2020, unless otherwise noted.

42:5.0.1.2.15.2.55	SUBJGRP 55	General
42:5.0.1.2.15.2.55.1	SECTION 512.200	512.200 Basis and scope of subpart.
42:5.0.1.2.15.2.55.2	SECTION 512.205	512.205 Definitions.
42:5.0.1.2.15.2.56	SUBJGRP 56	RO Model Participation
42:5.0.1.2.15.2.56.3	SECTION 512.210	512.210 RO participants and geographic areas.
42:5.0.1.2.15.2.56.4	SECTION 512.215	512.215 Beneficiary population.
42:5.0.1.2.15.2.56.5	SECTION 512.217	512.217 Identification of individual practitioners.
42:5.0.1.2.15.2.56.6	SECTION 512.220	512.220 RO participant compliance with RO Model requirements.
42:5.0.1.2.15.2.56.7	SECTION 512.225	512.225 Beneficiary notification.
42:5.0.1.2.15.2.57	SUBJGRP 57	Scope of RO Episodes Being Tested
42:5.0.1.2.15.2.57.8	SECTION 512.230	512.230 Criteria for determining cancer types.
42:5.0.1.2.15.2.57.9	SECTION 512.235	512.235 Included RT services.
42:5.0.1.2.15.2.57.10	SECTION 512.240	512.240 Included modalities.
42:5.0.1.2.15.2.57.11	SECTION 512.245	512.245 Included RO episodes.
42:5.0.1.2.15.2.58	SUBJGRP 58	Pricing Methodology
42:5.0.1.2.15.2.58.12	SECTION 512.250	512.250 Determination of national base rates.
42:5.0.1.2.15.2.58.13	SECTION 512.255	512.255 Determination of participant-specific professional episode payment and participant-specific technical episode payment amounts.
42:5.0.1.2.15.2.59	SUBJGRP 59	Billing and Payment
42:5.0.1.2.15.2.59.14	SECTION 512.260	512.260 Billing.
42:5.0.1.2.15.2.59.15	SECTION 512.265	512.265 Payment.
42:5.0.1.2.15.2.59.16	SECTION 512.270	512.270 Treatment of add-on payments under existing Medicare payment systems.
42:5.0.1.2.15.2.60	SUBJGRP 60	Data Reporting
42:5.0.1.2.15.2.60.17	SECTION 512.275	512.275 Quality measures, clinical data, and reporting.
42:5.0.1.2.15.2.61	SUBJGRP 61	Medicare Program Waivers
42:5.0.1.2.15.2.61.18	SECTION 512.280	512.280 RO Model Medicare program waivers.
42:5.0.1.2.15.2.62	SUBJGRP 62	Reconciliation and Review Process
42:5.0.1.2.15.2.62.19	SECTION 512.285	512.285 Reconciliation process.
42:5.0.1.2.15.2.62.20	SECTION 512.290	512.290 Timely error notice and reconsideration review process.

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