The 2020 calendar year is an educational and operations testing period for the new Appropriate Use Criteria (AUC) Program by the Centers for Medicare & Medicaid Services (CMS). Under this new program, when an advanced imaging service is ordered for a Medicare patient, the ordering professional will be required to consult AUC through a qualified clinical decision support mechanism. In preparation for full implementation in 2021, CMS encourages physicians to learn about the AUC program, inform their billing staff and vendors about the new codes and modifiers, and take advantage of the testing period. For claims processing requirements, refer to this CMS guide. For complete details, visit the AUC Program website. Note: Physicians who consult AUC for at least 90 days can receive credit for the MIPS Improvement Activities category under the 2020 QPP performance year by attesting to this high-weighted activity: “Consulting AUC Using Clinical Decision Support when Ordering Advanced Diagnostic Imaging.” For details, visit the QPP website.
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