Appropriate Use Criteria

The Protecting Access to Medicare Act (PAMA) requires that physicians ordering advanced imaging exams consult Appropriate Use Criteria (AUC) through a qualified Clinical Decision Support Mechanism (qCDSM).

​Ordering providers are required to consult AUC for all Medicare Part B Advanced Diagnostic Imaging Services (CT, MR, NM, PET).

Consultation is required in all applicable settings as outlined by CMS. These include physician offices, hospital outpatient departments (including emergency departments), ambulatory surgical centers, and independent diagnostic testing facilities.

January 1, 2020 marks the formal start of the program. Healthcare providers will be required consult a qualified CDSM when ordering advanced imaging tests.

Use the following documents to guide you through the AUC process:

NMC has partnered with CareSelect® as a Centers for Medicare and Medicaid Services (CMS) qCDSM to provide free AUC scoring consultations for referring orders to our Imaging Department. CareSelect provides a simple, secure, HIPAA compliant and user-friendly interface to take you through the AUC process.

Consults must be completed by, or under the direct supervision of, a clinically licensed individual or provider. If you need to use this service, visit URL FOR DIRECT LINK and set up accounts for all ordering professionals as soon as possible.