The Centers for Medicare and Medicaid Services (CMS) announced on its Appropriate Use Criteria Mandate (AUC) website that the payment penalty phase of the AUC Mandate will not begin on Jan. 1, 2023 as previously stated. CMS did not provide a timeframe for full implementation. The educational and operations testing period will continue until the agency releases additional details.

The Protecting Access to Medicare Act of 2014 (PAMA) included a provision requiring clinicians consult with AUC through a qualified clinical decision support mechanism when ordering advanced imaging services (i.e. SPECT/PET, MPI, CT and MRI) in order to receive payment approval from CMS. The agency has delayed the full implementation of the program numerous times due to questions around clinician and provider readiness as well as burdens related to the national public health emergency.

An explanation was not provided by CMS, but the ACC will inquire with CMS staff for any information beyond the posted notice.

Clinical Topics: Noninvasive Imaging, Computed Tomography, Magnetic Resonance Imaging, Nuclear Imaging

Keywords: ACC Advocacy, Centers for Medicare and Medicaid Services, U.S., Medicare, Decision Support Systems, Clinical, Area Under Curve, Public Health, Tomography, Emission-Computed, Single-Photon, Magnetic Resonance Imaging, Positron-Emission Tomography, Tomography, X-Ray Computed

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