Incomplete episode

Incomplete episode means an RO episode that is deemed not to have occurred because:
(1) A Technical participant or a Dual participant does not furnish a technical component to an RO beneficiary within 28 days following a Professional participant or the Dual participant furnishing an initial treatment planning service to that RO beneficiary;
(2) An RO beneficiary ceases to have traditional FFS Medicare as his or her primary payer at any time after the initial treatment planning service is furnished and before the date of service on a claim with an RO Model-specific HCPCS code and an EOE modifier; or
(3) An RO beneficiary switches RT provider or RT supplier before all included RT services in the RO episode have been furnished.

Source

42 CFR § 512.205

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Scoping language

For purposes of this subpart, the following definitions apply:

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