Appropriate Use Criteria
The Centers for Medicare and Medicaid Services (CMS) requires that
all providers ordering advanced diagnostic imaging services (MRI, CT,
PET, and Nuclear Medicine) consult the Appropriate Use Criteria
(AUC). This requirement has been imposed to ensure that the most
appropriate tests are ordered for patients and is an alternative to
requiring prior authorization for these services.
When ordering advanced imaging services, you must consult the
Appropriate Use Criteria through a CMS-approved Clinical Decision
Support Mechanism (CDSM). Without a documented consult, providers
will not receive Medicare reimbursement for the test.
Live Healthy Imaging is your resource for this new Appropriate Use Criteria requirement. For your reference, we have provided a link below for a free Clinical Decision Support Mechanism, should you not have this already built into your electronic medical records (EMR) system.
Care Select Imaging CDSM
Please visit CMS or ACR for additional information about this requirement.
Have a question? Feel free to call us directly at 832-344-3512 or send us a message on our contact page