Activity Description

Clinicians attest that they are consulting specified applicable AUC through a qualified clinical decision support mechanism for all applicable imaging services furnished in an applicable setting, paid for under an applicable payment system, and ordered on or after January 1, 2018. This activity is for clinicians that are early adopters of the Medicare AUC program (2018 performance year) and for clinicians that begin the Medicare AUC program in future years as specified in our regulation at §414.94. The AUC program is required under section 218 of the Protecting Access to Medicare Act of 2014. Qualified mechanisms will be able to provide a report to the ordering clinician that can be used to assess patterns of image-ordering and improve upon those patterns to ensure that patients are receiving the most appropriate imaging for their individual condition.

Objective

Consult Appropriate Use Criteria (AUC) through a clinical decision support (CDS) mechanism for imaging services to reduce unnecessary and potentially harmful over-imaging.

Validation

Documented consultation of specified AUC through a qualified CDS mechanism for imaging services. Include at least one of the following elements:

1. Early adopter status – Evidence of early adoption of the Medicare AUC program (2018 Performance Year); OR
2. Demonstration of standardized use of AUC in daily patient care – Provide reports, details of agreement with provider of services, detailed information about standardized process, etc.; OR
3. Image-ordering reports – Copies of reports (e.g., paper copy, screenshots) sent to the ordering clinician that can be used to assess patterns of image-ordering and improve upon those patterns to ensure that patients are receiving the most appropriate imaging for their individual condition.

Example(s)/Information:

• AUC Criteria program: www.cms.gov
• Qualified AUC mechanisms: www.cms.gov