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