April 21, 2017

ACR Answers Frequent Questions About CDS Mandate

The American College of Radiology (ACR) is providing answers to frequently asked questions (FAQs) and essential information to help members understand the implementation requirements of mandatory clinical decision support (CDS) and appropriate use criteria (AUC) for advanced medical imaging procedures ordered for Medicare beneficiaries.

Section 218(b) of the Protecting Access to Medicare Act of 2014 (PAMA) directed the Centers for Medicare and Medicaid Services (CMS) to establish a program to promote consultation of AUC by ordering physicians for Medicare beneficiaries who require advanced diagnostic imaging services. AUC are defined as criteria that are evidence based (to the extent feasible) and assist professionals who order and furnish applicable imaging services to make the most appropriate treatment decisions for specific clinical conditions.

Though PAMA mandated a Jan. 1, 2017, implementation date for CDS, a decision by CMS to use the Medicare Physician Fee Schedule rulemaking cycle to implement the program delayed the start of required AUC consultation until at least Jan. 1, 2018.

In the 2017 Medicare Physician Fee Schedule (MPFS) final rule, CMS officials indicated they continue to aggressively move forward to implement this AUC program. The first qualified clinical decision support mechanisms will be announced on June 30, 2017. The agency expects furnishing professionals, defined as physicians or practitioners who order an applicable imaging service, will be required to begin reporting AUC consultation on Jan. 1, 2018.

To address your specific questions, please contact Katie Keysor.