This letter is only meant as a notification.
No action is required on your part.

Oncology Care Model Beneficiary Notification Letter

________________________ is participating in a Medicare initiative called the
Oncology Care Model. You are receiving this letter because your health care provider has
identified you as a patient who is receiving care through this initiative. Oncology
practices participating in the Oncology Care Model, including
________________________, will work with Medicare to improve cancer care for
patients receiving chemotherapy.
Your Medicare rights have not been changed.
You still have all the same Medicare rights and protections, including the right to choose
which health care provider you see. However, because ________________________
chose to participate in the Oncology Care Model, all of ________________________’s
Medicare beneficiaries who meet the eligibility criteria of this initiative will receive care
under the initiative, including access to patient-focused services (listed below). If you do
not wish to receive care under the Oncology Care Model, you must choose a health care
provider who does not participate in this initiative to receive care. Regardless of which
health care provider you see, Medicare will continue to cover all of your medically
necessary services.
The Oncology Care Model aims to improve cancer care.
The Oncology Care Model was designed to help ensure that you receive the right care at
the right time by giving your health care provider extra resources to manage your cancer
care. Your health care provider will use these resources to give you access to the patientfocused services listed below. Medicare will monitor ________________________ to
make sure you and other people with Medicare receive quality care.
________________________ will regularly receive information from Medicare about its
participation in the initiative.
You will receive access to patient-focused services.
As part of the Oncology Care Model, ________________________ will give you access
to patient-focused services aimed at meeting your individual needs while you are
receiving chemotherapy or hormonal therapy. Under the initiative, you can:
• Contact a health care provider who has access to your medical records 24 hours a
day, 7 days a week

 This letter is only meant as a notification.
No action is required on your part.
• Work with your health care provider to create a detailed care plan that meets your
needs
• Work with your health care provider to access other patient-focused supportive
services
Talk to your health care provider to learn more about these patient-focused services.
These patient-focused services are called Enhanced Services, and Medicare pays for these
services via the Monthly Enhanced Oncology Services (MEOS) payment (G9678).
Claims for the MEOS payment will appear on your Medicare Summary Notice (MSN)
(Medicare billing statement) as “Oncology Care Model {OCM) Monthly Enhanced
Oncology Services {MEOS) payment for enhanced care manage {G9678).” Note that the
date of service on the MSN may be different from the date on which you actually
received services and a health care provider in the practice—other than the health care
provider you actually saw—may bill for that service. As shown under the “Maximum
You May Be Billed” section of the MSN for the MEOS claim, you will not be
responsible for paying for any portion of these patient-focused services; Medicare will
cover the full amount of these services.
Your feedback is important.
Medicare may also ask you to answer a survey about the services and care you received
from ________________________. The survey will be mailed to you. Your feedback
will help improve care for all people with Medicare who receive chemotherapy or
hormonal therapy.
Find more information.
For more information about the Oncology Care Model, you can:
• Visit www.innovation.cms.gov/initiatives/oncology-care/
• Call ________________________ at ________________________________
• Call 1-800-MEDICARE (1-800-663-4227). TTY users can call 1-877-486-2048
If you have concerns or complaints about your care, talk to your health care provider, or
contact your Beneficiary and Family Centered Quality Improvement Organization
(BFCC-QIO). To get your BFCC-QIO’s phone number, visit Medicare.gov/contacts or
call 1-800-MEDICARE.
To find a different health care provider, visit www.Medicare.gov/physiciancompare, or
call 1-800-MEDICARE.