GENERAL

• § 512.200 - Basis and scope of subpart.

• § 512.205 - Definitions.

RO MODEL PARTICIPATION

• § 512.210 - RO participants and geographic areas.

• § 512.215 - Beneficiary population.

• § 512.217 - Identification of individual practitioners.

• § 512.220 - RO participant compliance with RO Model requirements.

• § 512.225 - Beneficiary notification.

SCOPE OF RO EPISODES BEING TESTED

• § 512.230 - Criteria for determining cancer types.

• § 512.235 - Included RT services.

• § 512.240 - Included modalities.

• § 512.245 - Included RO episodes.

PRICING METHODOLOGY

• § 512.250 - Determination of national base rates.

• § 512.255 - Determination of participant-specific professional episode payment and participant-specific technical episode payment amounts.

BILLING AND PAYMENT

• § 512.260 - Billing.

• § 512.265 - Payment.

• § 512.270 - Treatment of add-on payments under existing Medicare payment systems.

DATA REPORTING

• § 512.275 - Quality measures, clinical data, and reporting.

MEDICARE PROGRAM WAIVERS

• § 512.280 - RO Model Medicare program waivers.

RECONCILIATION AND REVIEW PROCESS

• § 512.285 - Reconciliation process.

• § 512.290 - Timely error notice and reconsideration review process.

• § 512.292 - Overlap with other models tested under Section 1115A and CMS programs.

• § 512.294 - Extreme and uncontrollable circumstances.