Determining if you are an RO Model Participant?

1. You bill Radiation Therapy services to Medicare patients.
2. RO Model participation is required for a list of randomly selected zip codes. If the facility you are delivering services from fall in this zip code list, then you are a participant.

RO Model Zip codes: https://innovation.cms.gov/media/document/ro-model-zip-codes-list-nov2021

A RO participant can be either:

1. Professionally billing physicians or Physician Group Practices

   This includes freestanding centers as well as physicians working in a hospital but billing the professional service side.

2. Institutional environment

This includes hospital radiation therapy departments.

Participant Types:

1. A Professional participant is a Physician Group Practice, that furnishes only the professional component (PC) of RT services at either a freestanding radiation therapy center or a HOPD.  These services are often accompanied by a 26 modifier.
2. A Technical participant is a HOPD or freestanding radiation therapy center which furnishes only the technical component (TC) of RT services during an RO episode.
3. A Dual participant are global billers who furnish both the professional and technical components of a Radiation Oncology episode for RT services through a freestanding radiation therapy center.