CMS Appropriate Use Criteria

Beginning January 1, 2020, clinicians who order CT, MRI, Nuclear Medicine and PET studies on Medicare patients will be required to consult CMS-approved Appropriate Use Criteria via a CMS-approved Clinical Decision Support Module.  Payment penalties are set to take effect the later of January 1, 2023 or the January 1 following the end of the COVID 19 Public Health Emergency. These links will help our clinical partners gather the information necessary to comply with this requirement.

5 Things to Know About CMS Appropriate Use Criteria Mandate

Download this document to understand the requirement to consult Appropriate Use Criteria prior to advanced imaging orders.

All in order: It’s Time to Prepare for 2020 Imaging Clinical Decision Support Requirements

UIC Executive Director David Smith, FACMPE recently wrote an article for the Medical Group Management Associations Connection magazine, offering suggestions for ordering clinician offices preparing to consult Appropriate Use Criteria.

American College of Radiology AUC Resources

CMS Appropriate Use Criteria Program Web Pages

Free Clinical Decision Support Mechanism

National Decision Support Company CareSelect™

Have questions?   Email