| Ontario Health - Cancer Care Ontario's Data Book - 2021-2022 |
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Updated December 2020
The current brachytherapy reimbursement program is focused on prostate patients. The program reimburses Regional Cancer Centres (RCCs) for the costs of seeds and needles used in brachytherapy treatments. Reimbursement is contingent upon compliance with patient eligibility criteria developed based on an evidence-based summary for this treatment. In addition to being used for reimbursement, the prostate brachytherapy data are used to support program budgeting and cancer system planning.
The prostate brachytherapy database maintains a record of both patient eligibility/enrollment data and treatment data. To be eligible for reimbursement through the program, the RCC must submit eligibility/enrollment data as well as treatment data in compliance with monthly billing deadlines through a Web-based application.
The requirements for eligibility/enrollment data and treatment data are outlined below:
1. The RCC must submit this data and Ontario Health (Cancer Care Ontario) must process it before payment is made back to the RCC.
2. Each patient for whom the RCC is seeking reimbursement must be enrolled in the program by providing eligibility/enrollment data that include patient-specific demographic information and answers to a series of medical questions.
3. The required treatment data consists of
a) The quantities of each product (seeds and needles) used or discarded as a result of a qualified patient’s treatment.
b) The delivery costs associated with products used or discarded as a result a qualified patient’s treatment
The amount of reimbursement is the calculated from the total of:
1. The cost of the used or discarded products, based on a standard product cost and the reported quantities.
2. A flat rate delivery cost.