Is radiation oncology paid on an episode basis under Medicare in 2026?

No. Medicare pays radiation oncology fee-for-service in 2026. The RO Model was never implemented and ROCR is still a pending bill.

What happened to the CMS Radiation Oncology Model?

It was delayed indefinitely and shelved. Stakeholders objected to the size of its payment reductions and the reporting burden. ROCR was built to replace it while keeping the episode payment concept.

Which radiation therapy CPT codes changed on January 1, 2026?

Delivery consolidated into 77402, 77407 and 77412 across both settings. Codes 77385 and 77386 were deleted along with the delivery G-codes. Image guidance consolidated into 77387, professional component only.

What is the 2026 efficiency adjustment?

A 2.5% reduction CMS finalized to work RVUs and intraservice physician time for non-time-based services. Radiation oncology services fall in scope. CMS put the specialty-level impact at about -1%, but individual clinics vary widely.

Would ROCR reward hypofractionation?

It would remove the current penalty. Paying per patient rather than per fraction means a shorter evidence-based course no longer reduces revenue. Practices already using shorter protocols would benefit most.

Does TEAM apply to radiation oncology?

No. TEAM covers five surgical procedures at selected hospitals from 2026 through 2030. Radiation oncology isn’t included, and oncology inpatient admissions are excluded from episode spending.

How soon would a case rate take effect if ROCR passed?

Under the bill text, CMS must issue regulations within a year of enactment and the program takes effect a year after enactment. Practices would keep billing the current way through that window.

Radiation Oncology Billing 2026: Episode Payment Explained