RO Model
The Radiation Oncology (RO) Model has been released by CMS and is expected to go-live in 2023. It is a new way of performing billing and reimbursement for Radiotherapy. The RO Model is a testing ground for a new system and whether this prospective, site neutral, modality agnostic, episode-based payments can be successful at reducing Medicare expenditures while enhancing quality of care. The expectation or rather hope, is that the RO Model improves the patient experience by rewarding high-quality, patient care and incentivizes radiation oncology treatments which result in better patient outcomes.
Participation is mandatory for most Radiation Oncology providers throughout the United States when billing Medicare patients.
Radiation Oncology billing is already complicated and unfortunately, this new system complicates it further. It is far from simple and will massively complicate practice administration of Radiation Therapy centers. Centers will be required to not only bill using the traditional Fee For Service modality, but simultaneously implement this new system.
The new system has a long list of requirements and timing constraints in order for reimbursement to occur. Mistakes will be costly as rather than losing reimbursement on a per code basis; mistakes could result in wholesale loss of payment for an entire treatment course.
The best case scenario where the billing is performed perfectly will still result in a great deal of additional work load for staff and evaluation procedures for each patient.
However, Shavara Inc. has addressed this situation and features an automated solution in it’s specialized Radiation Oncology billing software Iridium Suite. Read more about the RO Model Solution here.
Additionally, we are providing RO Model resources here.
Please contact us if you would like to demo the RO Model Solution in Iridium Suite:
