CMS Announces RO Model Updates

The Centers for Medicare & Medicaid Services (CMS) announced its intent to delay the Radiation Oncology (RO) Model to July 1, 2021. The delay is included in the 2021 Hospital Outpatient Prospective Payment (OPPS) Final Rule (CMS-1736-FC) as an interim final rule with a comment period.

Due to the delay, the following changes have been made to the RO Model:

• The first performance year (PY) will be from July 1 to Dec. 21, 2021.
• The model performance period will be 4.5 years.
• CMS expects the Model to qualify as an Advanced Alternative Payment Model (APM) and a Merit-Based Incentive Payment System (MIPS) under the CMS Quality Payment Program (QPP) beginning in the PY2.
• Certified Electronic Health Record Technology will be a requirement starting in PY2.
• The individual practitioner list will still be required in PY1, but it will only be used for QPP in PY1 to assign an automatic 50 percent score for the Improvement Activity performance category in MIPS for RO participants.
• RO participants must, beginning in PY2, collect quality measures data from Jan. 1, 2022, through Dec. 31, 2022, and submit in March 2023.
• The collection period for clinical data elements will begin on Jan. 1, 2022. The first submission of the clinical data elements for Jan. 1, 2022, through June 30, 2022, will be due in July 2022.
• A CMS-approved contractor will administer the CAHPS® Cancer Care Survey for Radiation Therapy beginning in October 2021 instead of April 2021.

An updated version of the RO Model FAQs to reflect these changes is available.

RO Model Billing Webinar Update
This webinar has also been postponed to Jan. 13, 2021. Call in information for this webinar can be found here.

For any questions not answered in this update, you can reach out via email to CMS at: radiationtherapy@cms.hhs.gov. Additional information about the RO Model, including all changes, can be found on its website.

Posted 12/3/2020