When the Protecting Access to Medicare Act (PAMA) goes into effect on Jan. 1, 2020, referring providers will have to consult appropriate use criteria (AUC) through a decision support tool before ordering advanced imaging.
The American College of Radiology has released a toolkit to better explain the CMS mandate to referring providers after many members expressed concern about their referring provider’s lack of awareness on the mandate.
“These items provide background information and what should be included with applicable Medicare orders starting January 1,” according to an ACR release. “CMS is expected to publish detailed claims processing information this summer. We will then provide additional information to send to your referring physicians.”
Below are links from the first phase of the AUC toolkit:
The ACR also provided links to better inform referring providers:
- Medicare Learning Network AUC for Advanced Diagnostic Imaging Fact Sheet
- Customizable Letter that You Can Send to Referring Providers
Additional educational materials are available on the ACR’s clinical decision support page.