Clinical Decision Support Mechanisms

NOTICE: The EDUCATIONAL AND OPERATIONS TESTING PERIOD for the AUC Program has been extended beyond CY 2021. There are no payment consequences associated with the AUC program during the Educational and Operations Testing Period. We encourage stakeholders to use this period to learn, test and prepare for the AUC program. The payment penalty phase will begin on the later of January 1, 2023 or the January 1 that follows the declared end of the public health emergency (PHE) for COVID-19. For more information please review the CY 2022 Physician Fee Schedule Final Rule: https://www.govinfo.gov/content/pkg/FR-2021-11-19/pdf/2021-23972.pdf (pages 65224 - 65241)

Background

A Clinical Decision Support Mechanism (CDSM) is an interactive, electronic tool for use by clinicians that communicates appropriate use criteria (AUC) information to the user and assists them in making the most appropriate treatment decision for a patient’s specific clinical condition. They may be modules within or available through certified electronic health record (EHR) technology.

Applicants Seeking CDSM Qualification

  • Applications must document current adherence to the qualified CDSM requirements under 42 CFR 414.94(g)(1) OR how and when each requirement is reasonably expected to be met.
  • CMS has not provided an application template.
  • Send applications to ImagingAUC@cms.hhs.gov by January 1.

We will post qualified CDSMs to our website. All qualified CDSMs must re-apply every five years and applications must be received by January 1 during the fifth year of their approval.

Qualified Clinical Decision Support Mechanisms and Related Codes

(Additional information regarding codes is available on our Outreach and Education page in MLN Matters Article MM11268)

Mechanism Name Code
eviCore healthcare's Clinical Decision Support Mechanism G1001
MedCurrent OrderWise™ G1002
Medicalis Clinical Decision Support Mechanism G1003
National Decision Support Company CareSelect™* G1004
AIM Specialty Health ProviderPortal®* G1007
Cranberry Peak ezCDS G1008
Stanson Health's Stanson CDS G1010
AgileMD's Clinical Decision Support Mechanism G1012
EvidenceCare’s ImagingCare G1013
InveniQA's Semantic Answers in Medicine™ G1014
Reliant Medical Group CDSM G1015
Speed of Care CDSM G1016
HealthHelp's Clinical Decision Support Mechanism G1017
INFINX CDSM G1018
LogicNets AUC Solution G1019
Curbside Clinical Augmented Workflow     G1020
E*HealthLine Clinical Decision Support Mechanism     G1021
Intermountain Clinical Decision Support Mechanism     G1022
Persivia Clinical Decision Support     G1023
Radrite* G1011
*Free Tool Available
Information Collections Under 42 CFR 414.94
OMB Control Number: 0938-1315
Expiration Date: 03/31/2020

 

Page Last Modified:
12/01/2021 08:00 PM