Requirements of the AUC Program

  1. Ordering professionals must consult Appropriate Use Criteria (AUC) for advanced outpatient imaging (CT, MR, NM, PET) orders.
  2. Only AUCs from qualified Provider-Led Entities (qPLE) may be used under this program. 
  3. Ordering professionals must access AUCs through a qualified clinical decision support mechanism (qCDSM).
  4. Claims by furnishing professionals must specify CDS consultation (to be clarified in MPFS CY 2018 Rule).
  5. Ordering professionals identified as outliers must obtain preauthorization as soon as January 1, 2020.