Starting Jan. 1, 2020, the Protecting Access to Medicare Act (PAMA) requires referring providers to consult appropriate use criteria (AUC) via a CMS-qualified clinical decision support mechanism (qCDSM) prior to ordering CT, MR, Nuclear Medicine and PET exams for Medicare patients.
Starting in January, the mandatory AUC consult program will begin with a one-year “Educational and Operations” testing period (with no penalties on rendering physicians for incorrect reporting). After the testing period, rendering providers will not receive Medicare payment for the procedure without a correctly documented AUC consult.
What You Need to Know
The ACR can help educate you and your referring providers about the AUC mandate with a collection of information and tools, including:
- PAMA-AUC Toolkit
- Background Materials
- Tips and FAQs
Watch On Demand: ACR-RBMA “Medicare AUC Mandate – Countdown to Launch!” Webinar