U.S. Code of Federal Regulations

Regulations most recently checked for updates: Aug 27, 2025

All TitlesTitle 42Chapter IVPart 512Subpart B - Subpart B—Radiation Oncology Model

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.
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