Title 42

SECTION 512.245

512.245 Included RO episodes.

§ 512.245 Included RO episodes. Link to an amendment published at 85 FR 86305, Dec. 29, 2020.

(a) General. Any RO episode that begins on or after January 1, 2021, and ends on or before December 31, 2025, is included in the Model performance period.

(b) Death or election of hospice benefit. An RO episode is included in, and paid for under, the RO Model if the RO beneficiary dies after the TC of an RO episode has been initiated, or if the RO beneficiary elects the Medicare hospice benefit after the initial treatment planning service, provided that the TC is initiated within 28 days following the initial treatment planning service. Each RO participant will receive both installments of the episode payment under such circumstances, regardless of whether the RO beneficiary dies or elects the Medicare hospice benefit before the relevant course of RT treatment has ended.

(c) Clean periods. An RO episode must not be initiated for the same RO beneficiary during a clean period.

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