General

General Question for the Week of December 16, 2019

General Compliance Question of the Week

Question:

What is the time frame for AUC implementation? I’ve heard there will be no penalties for noncompliance in 2020.

Answer:

For the year 2020, the Appropriate Use Criteria (AUC) program will operate in an education and operations testing period when claims will not be denied if they fail to include proper AUC consultation. Inclusion and active participation are encouraged to transition accordingly. However, for 2021, failure to adhere will carry significant consequences. Expect to receive zero payment on claims that fail to comply. This means that payment will be denied for the professional and technical components along with any charges billed globally.


This question was answered in an edition of our Radiology Compliance Manager. For more hot topics relating to radiology services, please visit our store or call us at 1.800.252.1578, ext. 2.