42 CFR 512.230
§ 512.230 Criteria for determining cancer types.
United States · 42 CFR — Public Health · Status: effective
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- Citation
- 42 CFR 512.230, § 512.230 Criteria for determining cancer types, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/208173
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Full text
(a) Included cancer types. CMS includes in the RO Model cancer types that satisfy the following criteria:
(1) The cancer type is commonly treated with radiation per nationally recognized, evidence-based clinical treatment guidelines;
(2) The cancer type has one or more associated current ICD-10 codes that have demonstrated pricing stability; and
(3) The Secretary has not determined that the cancer type is not suitable for inclusion in the RO Model.
(b) Removing cancer types. CMS removes cancer types in the RO Model if it determines:
(1) That there is a ≥10 percent error in established national base rates; or
(2) The cancer type does not meet the criteria set forth in paragraph (a) of this section.
(c) ICD-10 codes for included cancer types. CMS displays on the RO Model website no later than 30 days prior to each PY the ICD-10 diagnosis codes associated with each included cancer type.
Legislative history
This is a federal regulation, adopted through agency rulemaking under the Administrative Procedure Act — not enacted by a recorded vote of Congress.