1996-2003

In the United States, the rates of imaging stress tests for Medicare enrollees varied widely by region. Diagnostic imaging tests grew more rapidly than any other type of physician service from 1999 to 2003.6-8

As the field of cardiovascular (CV) radionuclide imaging continued to advance along with other imaging modalities, the professional imaging community developed appropriateness criteria to support the delivery of quality CV care.9

2005

The American College of Cardiology partnered with the American Society of Nuclear Cardiology to develop AUC for single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI).9

Since then, AUC for other individual modalities have been developed.9

2013

The Multimodality AUC were developed, expanding to include appropriateness ratings for 7 cardiac testing modalities across 80 common patient indications.4

These Multimodality AUC replace prior AUC.4

2014

The Protecting Access to Medicare Act of 2014 directed CMS to establish a program promoting the use of AUC for advanced diagnostic imaging services.1

2015-2017

CMS introduced the Medicare AUC program and began implementation in a stepwise approach. Soon, for advanced imaging services provided to Medicare beneficiaries in the outpatient setting, applicable AUC will have to be consulted and documented using a qualified clinical decision support mechanism.1

Looking Ahead

July 2018-December 2019a

Healthcare providers will have the option to participate in a voluntary period of reporting AUC information to CMS.1

aDetails regarding the Medicare AUC program, including the implementation date, are subject to change without notice based on updates issued by CMS.

January 1, 2020a

Expected Effective Date

Ordering providers will be required to consult AUC; furnishing providers will be required to submit documentation about AUC.1

aDetails regarding the Medicare AUC program, including the implementation date, are subject to change without notice based on updates issued by CMS.

AUC are not intended to be used as a substitute for sound clinical judgment and practice experience, as the selection of appropriate imaging procedures may be influenced by local parameters. The ultimate objective of AUC is to improve patient care and health outcomes in a cost-effective manner.4