The Centers for Medicare and Medicaid Services (CMS) paused the Protecting Access to Medicare Act (PAMA) appropriate use criteria (AUC) program in the 2024 Medicare Physician Fee Schedule final rule. As a result, American College of Radiology® (ACR®) members and other healthcare providers may be unsure if they should continue to use AUC and Clinical Decision Support (CDS) systems. CMS continues to urge providers that already implemented CDS to continue their use as the agency considers pathways to move the program forward.
ACR recently hosted a webinar highlighting how facilities are using AUC and CDS to optimize imaging use in the inpatient and outpatient settings and in quality improvement initiatives. In some cases, facilities were able to negotiate with private insurers to replace imaging pre-authorization with CDS.
For questions about the status of the Medicare imaging AUC program, e-mail PAMA-AUC@acr.org.