Appropriate Use Criteria Program: CMS Updates

A few years ago, CMS introduced a new regulation for providers ordering Diagnostic Imaging studies.  This regulation would require practices/EMR’s to evaluate the necessity for an imaging order against a Clinical Decision Support Management system.  This program is known as the ‘Appropriate Use Criteria Program’.

Advanced imaging services would include examples such as the following:

  • computed tomography (CT)
  • positron emission tomography (PET)
  • nuclear medicine, and
  • magnetic resonance imaging (MRI)

The program was scheduled to go into effect on Jan 1, 2021.  This regulation has since been postponed and will not begin until Jan 1, 2022.

Given this, iSalus has paused our research and development efforts related to the Appropriate Use Criteria program until Q3 of 2021.  At that time, we will reevaluate. For more information on the regulation, please click here.