Imaging Clinical Decision Support
Imaging Appropriate Use Criteria
WHAT: An AUC consultation must occur for advanced diagnostic imaging services
that are performed in a physician’s office, a hospital outpatient
department (including an emergency department), an ambulatory surgical
center, an independent diagnostic testing facility (IDTF) or any other
provider-led outpatient setting CMS determines appropriate.
Advanced diagnostic imaging services include:Diagnostic magnetic resonance imaging, computed tomography, and nuclear
medicine (including positron emission tomography)
WHY: The purpose of the AUC program is to enable you to order the most appropriate test for your patient. The Centers for Medicare & Medicaid Services (CMS) will use data collected from the program to identify outlier ordering professionals who will become subject to prior authorization.
WHEN: Beginning in 2020, if you order Medicare Part B advanced diagnostic imaging services, you must consult appropriate use criteria (AUC) through a qualified Clinical Decision Support Mechanism
(CDSM). You must also provide the information to furnishing professionals and facilities, because they must report AUC consultation information on their Medicare claims. Until January 1, 2020, participating in the AUC program is voluntary. January 1, 2021 fines will be instituted for failure to participate.
NDSC Open Access Portal |
![]() •Free Website provided by National Decision Support Company (NDSC)
•Use for referring providers without an AUC integration in their EMR
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Download Guides HereAUC Fact Sheet- Click Here |
Appropriateness Criteria Scoring Guide - Click Here |
AUC Program Flyer - Click Here |
CareSelect Training VideoMeditech Training VideosProvider Order Workflow Video
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