New Clinical Decision Support requirement for Medicare
The Centers for Medicare & Medicaid Services (CMS) is requiring clinicians ordering advanced diagnostic imaging services (MRI, CT, PET/CT, Nuclear Medicine)
for Medicare Part B (outpatient) beneficiaries to consult appropriate use criteria (AUC) through a qualified Clinical Decision Support Mechanism (CDSM).
CMS is implementing this new requirement with a one-year Educational and Operations Testing Period during which claims will not be denied or delayed for
failing to include or misreporting AUC information.
We accept results from all federally qualified CDSMs. Additionally, all applicable services ordered through our Medical Professionals Portal consult
a qualified CDSM to comply with the new requirements.
We have a range of workflow solutions to help referring clinicians meet this new requirement. Whether ordering by fax, phone, interface or portal, we will
work with referring clinicians to ensure that all Medicare orders are processed appropriately.